Document Detail


Cost comparison of insulin glargine with insulin detemir in a basal-bolus regime with mealtime insulin aspart in type 2 diabetes in Germany.
MedLine Citation:
PMID:  20725588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the treatment costs of insulin glargine (IG; Lantus) to detemir (ID; Levemir), both combined with bolus insulin aspart (NovoRapid) in type 2 diabetes (T2D) in Germany.
METHODS: Cost comparison was based on data of a 1-year randomised controlled trial. IG was administered once daily and ID once (57% of patients) or twice daily (43%) according to treatment response. At the end of the trial, mean daily basal insulin doses were 0.59 U/kg (IG) and 0.82 U/kg (ID). Aspart doses were 0.32 U/kg (IG) and 0.36 U/kg (ID). Costs were calculated from the German statutory health insurance (SHI) perspective using official 2008 prices. Sensitivity analyses were performed to test robustness of the results.
RESULTS: Annual basal and bolus insulin costs per patient were euro 1,473 (IG) and euro 1,940 (ID). The cost of lancets and blood glucose test strips were euro 1,125 (IG) and euro 1,286 (ID). Annual costs for needles were euro 393 (IG) and euro 449 (ID). The total annual cost per patient of administering IG was euro 2,991 compared with euro 3,675 for ID, translating into a 19% annual cost difference of euro 684/patient. Base case results were robust to varying assumptions for insulin dose, insulin price, change in weight and proportion of ID once daily administrations.
CONCLUSION: IG and ID basal-bolus regimes have comparative safety and efficacy, based on the Hollander study, IG however may represent a significantly more cost saving option for T2D patients in Germany requiring basal-bolus insulin analogue therapy with potential annual cost savings of euro 684/patient compared to ID.
Authors:
Stefan Pscherer; Eva Susanne Dietrich; Franz-Werner Dippel; Aileen Rae Neilson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-05
Journal Detail:
Title:  German medical science : GMS e-journal     Volume:  8     ISSN:  1612-3174     ISO Abbreviation:  Ger Med Sci     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-09-29     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101227686     Medline TA:  Ger Med Sci     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
Affiliation:
Klinikum Traunstein, Germany.
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MeSH Terms
Descriptor/Qualifier:
Blood Glucose Self-Monitoring / economics
Cost Savings
Costs and Cost Analysis
Diabetes Mellitus, Type 2 / diagnosis,  drug therapy*,  economics*
Drug Costs / statistics & numerical data
Germany
Humans
Hypoglycemic Agents / administration & dosage,  economics
Insulin / administration & dosage,  analogs & derivatives*,  economics
Insulin, Long-Acting
Insurance, Health / economics,  statistics & numerical data
Models, Econometric
Needles / economics
Randomized Controlled Trials as Topic / statistics & numerical data
Reagent Strips / economics
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Insulin; 0/Insulin, Long-Acting; 0/Reagent Strips; 0/glargine; 0/insulin detemir
Comments/Corrections

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