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Evaluating the cost-effectiveness of reduced mild hypoglycaemia in subjects with Type 1 diabetes treated with Insulin detemir or NPH insulin in Denmark, Sweden, Finland and the Netherlands.
MedLine Citation:
PMID:  21951030     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims:  To estimate short-term cost-effectiveness of insulin detemir vs. NPH insulin based on the incidence of mild hypoglycaemia in subjects with Type 1 diabetes in Denmark, Sweden, Finland and the Netherlands. Methods:  A model was developed to evaluate cost-effectiveness based on mild (self-treated) hypoglycaemia and pharmacy costs over 1 year. Published rates of mild hypoglycaemia were used for NPH insulin and insulin detemir. Effectiveness was calculated in terms of quality-adjusted life expectancy. Pharmacy costs were accounted using published prices and defined daily doses for both insulins. Costs were expressed in 2010 euros (€). Results:  Treatment with insulin detemir was associated with fewer mild hypoglycaemic events than NPH insulin (mean rates of 26.3 vs. 35.5 events per person-year), leading to an improvement in mean quality-adjusted life expectancy of approximately 0.019 (0.030) quality-adjusted life years (standard deviation). Annual costs were € 573.55 (110.42) vs. € 332.76 (62.18) in Denmark for insulin detemir and NPH insulin, respectively. These values were € 545.79 (106.54) vs. € 306.12 (57.78) in Sweden, € 720.10 (140.74) vs. € 408.73 (78.61) in Finland and € 584.01 (109.47) vs. € 359.60 (64.84) in the Netherlands. Incremental cost-effectiveness ratios were approximately € 12 644 (Denmark), € 12 612 (Sweden), € 16 568 (Finland) and € 12 216 (the Netherlands) per quality-adjusted life year gained for insulin detemir vs. NPH insulin. Conclusions:  Insulin detemir is likely to be cost-effective vs. NPH insulin in subjects with Type 1 diabetes in Denmark, Sweden, Finland and the Netherlands. Increased pharmacy costs with insulin detemir should not be a barrier to therapy based on these findings.
Authors:
W J Valentine; J Jendle; M Saraheimo; B Thorsteinsson; R F Pollock; M Lammert
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-27
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  -     ISSN:  1464-5491     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Journal compilation © 2011 Diabetes UK.
Affiliation:
Ossian Health Economics and Communications GmbH, Basel, Switzerland Faculty of Health Sciences, Örebro University, Örebro, Sweden Folkhälsan Research Centre, Helsinki University, Helsinki, Finland Department of Cardiology and Endocrinology, Hillerød Hospital, Hillerød Faculty of Health Sciences, University of Copenhagen Novo Nordisk Scandinavia, Copenhagen, Denmark.
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