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Cost-effectiveness analysis of IDegLira versus basal-bolus insulin for patients with type 2 diabetes in the Slovak health system

Authors Psota M, Psenkova MB, Racekova N, Ramirez de Arellano A, Vandebrouck T, Hunt B

Received 2 June 2017

Accepted for publication 19 September 2017

Published 12 December 2017 Volume 2017:9 Pages 749—762


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Dean Smith

Marek Psota,1 Maria Bucek Psenkova,1 Natalia Racekova,2 Antonio Ramirez de Arellano,3 Tom Vandebrouck,4 Barnaby Hunt5

1Pharm-In, Ltd., 2Novo Nordisk Ltd., Bratislava, Slovakia; 3Novo Nordisk Ltd., Madrid, Spain; 4Novo Nordisk nv, Brussels, Belgium; 5Ossian Health Economics and Communications, Basel, Switzerland

Aims: To investigate the cost-effectiveness of once-daily insulin degludec/liraglutide (IDegLira) versus basal-bolus therapy in patients with type 2 diabetes not meeting glycemic targets on basal insulin from a healthcare payer perspective in Slovakia.
Methods: Long-term clinical and economic outcomes for patients receiving IDegLira and basal-bolus therapy were estimated using the IMS CORE Diabetes Model based on a published pooled analysis of patient-level data.
Results: IDegLira was associated with an improvement in quality-adjusted life expectancy of 0.29 quality-adjusted life years (QALYs) compared with basal-bolus therapy. The average lifetime cost per patient in the IDegLira arm was EUR 2,449 higher than in the basal-bolus therapy arm. Increased treatment costs with IDegLira were partially offset by cost savings from avoided diabetes-related complications. IDegLira was highly cost-effective versus basal-bolus therapy with an incremental cost-effectiveness ratio of EUR 8,590 per QALY gained, which is well below the cost-effectiveness threshold set by the law in Slovakia.
Conclusion: IDegLira is cost-effective in Slovakia, providing a simple option for intensification of basal insulin therapy without increasing the risk of hypoglycemia or weight gain and with fewer daily injections than a basal-bolus regimen.

Keywords: IDegLira, cost-effective, basal-bolus, insulin intensification, type 2 diabetes

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