University of Hertfordshire

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Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus: A Cost-Utility Analysis

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Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus : A Cost-Utility Analysis. / Dawoud, Dalia; Fenu, Elisabetta; Higgins, Bernard; Wonderling, David; Amiel, Stephanie A.

In: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, Vol. 20, No. 10, 01.12.2017, p. 1279-1287.

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Dawoud, Dalia ; Fenu, Elisabetta ; Higgins, Bernard ; Wonderling, David ; Amiel, Stephanie A. / Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus : A Cost-Utility Analysis. In: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 2017 ; Vol. 20, No. 10. pp. 1279-1287.

Bibtex

@article{df7aecc62a8f43b698ea4a318ad1c671,
title = "Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus: A Cost-Utility Analysis",
abstract = "OBJECTIVES: To assess the cost-effectiveness of basal insulin regimens for adults with type 1 diabetes mellitus in England.METHODS: A cost-utility analysis was conducted in accordance with the National Institute for Health and Care Excellence reference case. The UK National Health Service and personal and social services perspective was used and a 3.5% discount rate was applied for both costs and outcomes. Relative effectiveness estimates were based on a systematic review of published trials and a Bayesian network meta-analysis. The IMS CORE Diabetes Model was used, in which net monetary benefit (NMB) was calculated using a threshold of £20,000 per quality-adjusted life-year (QALY) gained. A wide range of sensitivity analyses were conducted.RESULTS: Insulin detemir (twice daily) [iDet (bid)] had the highest mean QALY gain (11.09 QALYs) and NMB (£181,456) per patient over the model time horizon. Compared with the lowest cost strategy (insulin neutral protamine Hagedorn once daily), it had an incremental cost-effectiveness ratio of £7844/QALY gained. Insulin glargine (od) [iGlarg (od)] and iDet (od) were ranked as second and third, with NMBs of £180,893 and £180,423, respectively. iDet (bid) remained the most cost-effective treatment in all the sensitivity analyses performed except when high doses were assumed (>30% increment compared with other regimens), where iGlarg (od) ranked first.CONCLUSIONS: iDet (bid) is the most cost-effective regimen, providing the highest QALY gain and NMB. iGlarg (od) and iDet (od) are possible options for those for whom the iDet (bid) regimen is not acceptable or does not achieve required glycemic control.",
keywords = "Adult, Bayes Theorem, Blood Glucose/drug effects, Computer Simulation, Cost-Benefit Analysis, Diabetes Mellitus, Type 1/drug therapy, England, Female, Humans, Hypoglycemic Agents/administration & dosage, Insulin Detemir/administration & dosage, Insulin Glargine/administration & dosage, Insulin, Isophane/administration & dosage, Male, Middle Aged, Models, Economic, Quality-Adjusted Life Years, Young Adult",
author = "Dalia Dawoud and Elisabetta Fenu and Bernard Higgins and David Wonderling and Amiel, {Stephanie A}",
note = "Copyright {\textcopyright} 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.",
year = "2017",
month = dec,
day = "1",
doi = "10.1016/j.jval.2017.05.021",
language = "English",
volume = "20",
pages = "1279--1287",
journal = "Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research",
issn = "1098-3015",
publisher = "Elsevier Ltd",
number = "10",

}

RIS

TY - JOUR

T1 - Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus

T2 - A Cost-Utility Analysis

AU - Dawoud, Dalia

AU - Fenu, Elisabetta

AU - Higgins, Bernard

AU - Wonderling, David

AU - Amiel, Stephanie A

N1 - Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - OBJECTIVES: To assess the cost-effectiveness of basal insulin regimens for adults with type 1 diabetes mellitus in England.METHODS: A cost-utility analysis was conducted in accordance with the National Institute for Health and Care Excellence reference case. The UK National Health Service and personal and social services perspective was used and a 3.5% discount rate was applied for both costs and outcomes. Relative effectiveness estimates were based on a systematic review of published trials and a Bayesian network meta-analysis. The IMS CORE Diabetes Model was used, in which net monetary benefit (NMB) was calculated using a threshold of £20,000 per quality-adjusted life-year (QALY) gained. A wide range of sensitivity analyses were conducted.RESULTS: Insulin detemir (twice daily) [iDet (bid)] had the highest mean QALY gain (11.09 QALYs) and NMB (£181,456) per patient over the model time horizon. Compared with the lowest cost strategy (insulin neutral protamine Hagedorn once daily), it had an incremental cost-effectiveness ratio of £7844/QALY gained. Insulin glargine (od) [iGlarg (od)] and iDet (od) were ranked as second and third, with NMBs of £180,893 and £180,423, respectively. iDet (bid) remained the most cost-effective treatment in all the sensitivity analyses performed except when high doses were assumed (>30% increment compared with other regimens), where iGlarg (od) ranked first.CONCLUSIONS: iDet (bid) is the most cost-effective regimen, providing the highest QALY gain and NMB. iGlarg (od) and iDet (od) are possible options for those for whom the iDet (bid) regimen is not acceptable or does not achieve required glycemic control.

AB - OBJECTIVES: To assess the cost-effectiveness of basal insulin regimens for adults with type 1 diabetes mellitus in England.METHODS: A cost-utility analysis was conducted in accordance with the National Institute for Health and Care Excellence reference case. The UK National Health Service and personal and social services perspective was used and a 3.5% discount rate was applied for both costs and outcomes. Relative effectiveness estimates were based on a systematic review of published trials and a Bayesian network meta-analysis. The IMS CORE Diabetes Model was used, in which net monetary benefit (NMB) was calculated using a threshold of £20,000 per quality-adjusted life-year (QALY) gained. A wide range of sensitivity analyses were conducted.RESULTS: Insulin detemir (twice daily) [iDet (bid)] had the highest mean QALY gain (11.09 QALYs) and NMB (£181,456) per patient over the model time horizon. Compared with the lowest cost strategy (insulin neutral protamine Hagedorn once daily), it had an incremental cost-effectiveness ratio of £7844/QALY gained. Insulin glargine (od) [iGlarg (od)] and iDet (od) were ranked as second and third, with NMBs of £180,893 and £180,423, respectively. iDet (bid) remained the most cost-effective treatment in all the sensitivity analyses performed except when high doses were assumed (>30% increment compared with other regimens), where iGlarg (od) ranked first.CONCLUSIONS: iDet (bid) is the most cost-effective regimen, providing the highest QALY gain and NMB. iGlarg (od) and iDet (od) are possible options for those for whom the iDet (bid) regimen is not acceptable or does not achieve required glycemic control.

KW - Adult

KW - Bayes Theorem

KW - Blood Glucose/drug effects

KW - Computer Simulation

KW - Cost-Benefit Analysis

KW - Diabetes Mellitus, Type 1/drug therapy

KW - England

KW - Female

KW - Humans

KW - Hypoglycemic Agents/administration & dosage

KW - Insulin Detemir/administration & dosage

KW - Insulin Glargine/administration & dosage

KW - Insulin, Isophane/administration & dosage

KW - Male

KW - Middle Aged

KW - Models, Economic

KW - Quality-Adjusted Life Years

KW - Young Adult

U2 - 10.1016/j.jval.2017.05.021

DO - 10.1016/j.jval.2017.05.021

M3 - Article

C2 - 29241887

VL - 20

SP - 1279

EP - 1287

JO - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

JF - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

SN - 1098-3015

IS - 10

ER -