Cost-effectiveness of Insulin Degludec Versus Insulin Glargine in Insulin-naive Chinese Patients With Type 2 Diabetes

Abstract Purpose The goal of this study was to investigate the long-term economic outcomes of insulin degludec versus insulin glargine use in Chinese patients with type 2 diabetes mellitus (T2DM) whose oral antidiabetic drugs did not provide sufficient glycemic control. Methods A published and validated Chinese diabetes health policy model, which reflects Chinese T2DM epidemiologic profiles, was used to assess the lifetime economic outcomes of microvascular and macrovascular complications and mortality. Efficacy and safety, medical expenditure, and utility data were derived from the literature, which were assigned to model variables for estimating the quality-adjusted life-years (QALYs) and costs, as well as incremental cost-effectiveness ratios. The analysis was conducted from the perspective of Chinese health care service providers. One-way and probabilistic sensitivity analyses were performed. Findings Compared with insulin glargine, insulin degludec was associated with 0.0053 QALY at an additional cost of $3278 in our simulated cohort. This outcome resulted in an incremental cost-effectiveness ratio of insulin degludec over insulin glargine of $613,443 per QALY gained. The one-way sensitivity analyses indicated that the results were sensitive to several model inputs. Implications Insulin degludec is unlikely to be cost-effective compared with insulin glargine for Chinese patients with T2DM whose disease is inadequately controlled with oral antidiabetic drugs.