德谷胰岛素对比甘精胰岛素在基础胰岛素联合餐时胰岛素疗法中治疗中国2型糖尿病的成本-效用分析

Cost-Utility Analysis of Insulin Degludec versus Insulin Glargine U100 in Basal-Bolus Regimens for Type 2 Diabetes in China

目的评估德谷胰岛素与甘精胰岛素100 U/ml治疗接受基础胰岛素联合餐时胰岛素的中国2型糖尿病患者长期成本-效用。方法使用IMS CORE糖尿病模型(CORE模型)模拟治疗30年的成本和健康产出。临床效果参数来自KIDUNA研究的亚组结果。成本费用基于中国本地价格而计算。成本和健康产出的贴现率均使用3%。采用单因素敏感性分析和概率敏感性分析评估结果的稳健性。结果与甘精胰岛素相比,德谷胰岛素治疗组增加了1.13质量调整生命年(QALYs),总成本节约10 865元。健康产出的改善主要来源德谷胰岛素治疗后糖尿病相关并发症发生率降低,总体节约主要来源于严重低血糖事件成本的减少。结论在基础胰岛素联合餐时胰岛素治疗的中国2型糖尿病患者中,与甘精胰岛素相比较,德谷胰岛素能节约成本并改善健康产出,是经济学更优的方案。

Objective To evaluate the long-term cost-utility analysis of insulin degludec(IDeg)versus insulin glargine 100 units/ml(IGlar U100)on treatment of type 2 diabetes mellitus(T2 DM)receiving basal–bolus insulin therapy in China.Methods The cost and health outcomes of 30 years of treatment were simulated using the IMS CORE Diabetes Model(CORE model).Patient clinical data were obtained from results of KIDUNA3 study in East Asian population.Costs were calculated based on local Chinese prices.The discounting rate was 3%was used for both cost and health outcomes.One-way and probabilistic sensitivities analysis were conducted to assess the robustness of the results.Results Compared with insulin glargine,IDeg could obtain more quality-adjusted life-years(QALYs)of 1.13,with healthcare cost of CNY 10865.The main source of improvement in health outcomes was the reduction in the incidence of diabetes-related complications after insulin treatment.The overall savings were mainly due to the reduction in the cost of severe hypoglycemic events.Conclusion In Chinese patients with type 2 diabetes mellitus treated with basal insulin combined with insulin,deguar insulin can save costs and improve health outcomes compared with insulin glargine,which is a more economical solution.