Pharmacoeconomic analysis of modern Insulin analogues in the treatment of diabetes mellitus type 2
Study purpose: To determine preferential medicinal products for the treatment of diabetes mellitus type 2 in terms of pharmacoeconomic analysis based on comparative cost and efficacy, safety and quality of life ratio between the modern insulin analogues.
Materials and methods: Study design – retrospective, modeling. Methods of pharmacoeconomic analysis - cost-effectiveness, costutility. Alternatives compared – insulin aspart (NovoRapid®), insulin lispro (Humalog®), insulin glulisine (Apidra®), premix insulin aspart 30/70 (NovoMix® 30), premix insulin lispro 25/75 (HumalogMix® 25), insulin detemir (Levemir®) and insulin glargine (Lantus®).
Data sources: efficacy – analysis of publications on clinical studies performed; medicinal product prices – registry of quoted prices for vital and essential medicines; cost of healthcare resources – outpatient and polyclinical assistance standards.
Study results: Among short-acting insulin analogues, CER value was 1091.84 rub.; 1133.55 rub. and 1175,27 rub. for NovoRapid®, Humalog® and Apidra®, respectively. Among premix insulin analogues, CER value was 1418.47 rub. for NovoMix® 30 and 1512.08 rub. for HumalogMix® 25. Among basal insulin analogues CER value was 2084.39 rub. for Levemir® and 2471.23 rub. – for Lantus®. Costutility analysis for NovoRapid®, Humalog®, Apidra®, NovoMix® 30, HumalogMix® 25, Levemir® and Lantus® CUR value was 84463.04 rub., 87689.69 rub., 90917.35 rub., 99573.21 rub., 106144.38 rub., 79269.45 rub. and 93981.16 rub. for 1 QALY, respectively. Therefore, in terms of costutility, when insulins were added to OAD treatment, NovoRapid® is the preferable drug because of the lowest CUR value. Among premix and basal insulin analogues, NovoMix® 30 and Levemir® were preferable drugs because of the lowest CUR values in their group.