1. Evaluating the cost-effectiveness of reduced mild hypoglycaemia in subjects with Type 1 diabetes treated with insulin detemir or NPH insulin in Denmark, Sweden, Finland and the Netherlands.
- Author
-
Valentine WJ, Jendle J, Saraheimo M, Thorsteinsson B, Pollock RF, and Lammert M
- Subjects
- Cost-Benefit Analysis, Denmark, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 drug therapy, Female, Finland, Humans, Hypoglycemia drug therapy, Hypoglycemic Agents therapeutic use, Insulin Detemir, Insulin, Isophane therapeutic use, Insulin, Long-Acting therapeutic use, Male, Netherlands, Quality-Adjusted Life Years, Sweden, Diabetes Mellitus, Type 1 economics, Hypoglycemia economics, Hypoglycemic Agents economics, Insulin, Isophane economics, Insulin, Long-Acting economics, Pharmacies economics
- Abstract
Aims: To estimate short-term cost-effectiveness of insulin detemir vs. NPH insulin based on the incidence of mild hypoglycaemia in subjects with Type 1 diabetes in Denmark, Sweden, Finland and the Netherlands., Methods: A model was developed to evaluate cost-effectiveness based on mild (self-treated) hypoglycaemia and pharmacy costs over 1 year. Published rates of mild hypoglycaemia were used for NPH insulin and insulin detemir. Effectiveness was calculated in terms of quality-adjusted life expectancy. Pharmacy costs were accounted using published prices and defined daily doses for both insulins. Costs were expressed in 2010 euros (€)., Results: Treatment with insulin detemir was associated with fewer mild hypoglycaemic events than NPH insulin (mean rates of 26.3 vs. 35.5 events per person-year), leading to an improvement in mean quality-adjusted life expectancy of approximately 0.019 (0.030) quality-adjusted life years (standard deviation). Annual costs were € 573.55 (110.42) vs. € 332.76 (62.18) in Denmark for insulin detemir and NPH insulin, respectively. These values were € 545.79 (106.54) vs. € 306.12 (57.78) in Sweden, € 720.10 (140.74) vs. € 408.73 (78.61) in Finland and € 584.01 (109.47) vs. € 359.60 (64.84) in the Netherlands. Incremental cost-effectiveness ratios were approximately € 12,644 (Denmark), € 12,612 (Sweden), € 16,568 (Finland) and € 12,216 (the Netherlands) per quality-adjusted life year gained for insulin detemir vs. NPH insulin., Conclusions: Insulin detemir is likely to be cost-effective vs. NPH insulin in subjects with Type 1 diabetes in Denmark, Sweden, Finland and the Netherlands. Increased pharmacy costs with insulin detemir should not be a barrier to therapy based on these findings., (© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.)
- Published
- 2012
- Full Text
- View/download PDF