Cost–utility analysis and drug pricing of once-weekly insulin icodec versus once-daily insulin degludec for type 2 diabetes patients treated with basal insulin in China

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism Pub Date : 2024-09-30 DOI:10.1111/dom.15973

Shanshan Hu MPharm, Shuowen Wang MPharm, Shengying Gu PharmD, Chendong Qi MPharm, Chenyang Shi PharmD, Guorong Fan PharmD

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Abstract

Aim

Insulin icodec is a first once-weekly administration basal insulin analogue for type 2 diabetes. This study aimed to investigate the price range of icodec for type 2 diabetes in the Chinese market, taking insulin degludec as reference.

Materials and Methods

Long-term health outcomes and costs for icodec and degludec were simulated using the United Kingdom Prospective Diabetes Study Outcomes Model (version 2.1) over 40 years from the Chinese healthcare provider's perspective. The efficacy and safety data were obtained from the ONWARDS 2 trial (Switching to once-weekly insulin icodec versus once-daily insulin degludec in individuals with basal insulin-treated type 2 diabetes (ONWARDS 2): a phase 3a, randomised, open label, multicentre, treat-to-target trial). Cost–utility analysis and a binary search were used to investigate the price range of icodec. Sensitivity analyses were performed to verify the robustness of the base-case analysis results.

Results

After a 40-year simulation, the quality-adjusted life years (QALY) of icodec and degludec were 10.32 and 10.28 years, respectively. At the initial assumption of the same annual costs of icodec and degludec of $455.40, icodec was the dominant therapy compared with degludec, with higher QALYs and lower total cost. After the binary search, we observed that the annual cost range of icodec was $625.17–$855.25. This cost range was finally adjusted to be $597.66–$736.34 using one-way sensitivity analysis and confirmed using probabilistic sensitivity analysis and scenario analysis. The scenario analysis revealed that the annual cost range of icodec could be $506.70–$736.34 if the price of degludec decreased by 20% in the future.

Conclusion

Insulin icodec appears to be more cost effective than degludec if the annual cost of icodec ranges from $597.66 to $736.34 for patients with type 2 diabetes in China.

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在中国，对使用基础胰岛素治疗的 2 型糖尿病患者进行每周一次胰岛素 icodec 与每日一次胰岛素 degludec 的成本效用分析和药品定价。

目的：胰岛素icodec是首个每周给药一次的2型糖尿病基础胰岛素类似物。本研究旨在以格列喹酮胰岛素为参考，调查中国市场上 2 型糖尿病患者使用艾可达胰岛素的价格范围：从中国医疗服务提供者的角度，使用英国前瞻性糖尿病研究结果模型（2.1 版）模拟了 icodec 和 degludec 长达 40 年的长期健康结果和成本。疗效和安全性数据来自ONWARDS 2试验（基础胰岛素治疗的2型糖尿病患者改用每周一次的伊科达克胰岛素与每日一次的德格列奈胰岛素（ONWARDS 2）：3a期、随机、开放标签、多中心、目标治疗试验）。成本效用分析和二元搜索用于调查 icodec 的价格范围。为验证基础案例分析结果的稳健性，还进行了敏感性分析：经过 40 年的模拟，icodec 和 degludec 的质量调整生命年（QALY）分别为 10.32 年和 10.28 年。在最初假设 icodec 和 degludec 的年成本相同为 455.40 美元的情况下，icodec 与 degludec 相比，QALY 更高而总成本更低，是最主要的疗法。经过二元搜索，我们发现 icodec 的年度成本范围为 625.17 美元至 855.25 美元。通过单向敏感性分析，最终将这一成本范围调整为 597.66 美元-736.34 美元，并通过概率敏感性分析和情景分析予以确认。情景分析表明，如果未来 degludec 的价格下降 20%，胰岛素 icodec 的年成本范围可能为 506.70 美元-736.34 美元：结论：如果中国 2 型糖尿病患者使用 icodec 胰岛素的年成本在 597.66 美元至 736.34 美元之间，则 icodec 胰岛素似乎比 degludec 更具成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.