An exploratory analysis of the cost‐effectiveness of insulin glargine 300units/mL versus insulin glargine 100units/mL over a lifetime horizon using the BRAVO diabetes model

• Published in: Diabetic medicine Vol. 41; no. 5
• Main Authors: Shao, Hui, Shi, Lizheng, Fonseca, Vivian, Abdul Jabbar Omar Alsaleh, Gill, Jasvinder, Nicholls, Charlie
• Format: Journal Article
• Language: English
• Published: London Wiley Subscription Services, Inc 01.05.2024
• Subjects: Costs; Diabetes; Diabetes mellitus (non-insulin dependent); Insulin; Sensitivity analysis; United States > US
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.15303

BackgroundThis analysis assessed the cost‐effectiveness of insulin glargine 300 units/mL (Gla‐300) versus insulin glargine 100 units/mL (Gla‐100) in insulin‐naïve adults with type 2 diabetes (T2D) inadequately controlled with oral antidiabetic drugs (OADs).MethodsCosts and outcomes for Gla‐300 versus Gla‐100 from a US healthcare payer perspective were assessed using the BRAVO diabetes model. Baseline clinical data were derived from EDITION‐3, a 12‐month randomized controlled trial comparing Gla‐300 with Gla‐100 in insulin‐naïve adults with inadequately controlled T2D on OADs. Treatment costs were calculated based on doses observed in EDITION‐3 and 2020 US net prices, while costs for complications were based on published literature. Lifetime costs ($US) and quality‐adjusted life‐years (QALYs) were predicted and used to calculate incremental cost‐effectiveness ratio (ICER) estimates; extensive scenario and sensitivity analyses were conducted.ResultsLifetime medical costs were estimated to be $353,441 and $352,858 for individuals receiving Gla‐300 and Gla‐100 respectively; insulin costs were $52,613 and $50,818. Gla‐300 was associated with a gain of 8.97 QALYs and 21.12 life‐years, while Gla‐100 was associated with a gain of 8.89 QALYs and 21.07 life‐years. This resulted in an ICER of $7522/QALY gained for Gla‐300 versus Gla‐100. Thus, Gla‐300 was cost‐effective versus Gla‐100 based on a willingness‐to‐pay threshold of $50,000/QALY. Compared with Gla‐100, Gla‐300 provided a net monetary benefit of $3290. Scenario and sensitivity analyses confirmed the robustness of the base case.ConclusionGla‐300 may be a cost‐effective treatment option versus Gla‐100 over a lifetime horizon for insulin‐naïve people in the United States with T2D inadequately controlled on OADs.