Cost-effectiveness of insulin analogs.
OBJECTIVE
To examine the cost-effectiveness of analogs versus human insulins, citing primarily studies conducted in the United States.


METHODS
The use of insulin analogs in type 1 and type 2 diabetes mellitus provides a better balance between glycemic control and hypoglycemia compared with human insulins, with the resultant potential to reduce the costs of treatment of hospitalization and chronic complications. The lower incidence of hypoglycemia seen with analogs versus human insulins may help to overcome barriers to insulin acceptance among patients with type 2 diabetes mellitus. In type 2 diabetes mellitus, prompt initiation or intensification of insulin therapy could save costs by delaying the development of complications.


METHODS
The cost-effectiveness of analogs was analyzed through a literature review. Searches were conducted in PubMed to identify articles in the past 5 years with the name of any insulin analog plus the word cost or economic in the title or abstract. American Diabetes Association abstracts for 2005 to 2007 were also searched.


RESULTS
Pharmacoeconomic modeling studies have consistently shown that insulin analogs provide gains in quality-adjusted life-years at costs well below accepted cost-effectiveness limits. In these studies, increased prescription costs were offset by reductions in complications. Retrospective analyses of healthcare databases have also shown cost-effectiveness for analogs versus human insulins, primarily because of lower inpatient care costs.


CONCLUSIONS
Treatment with insulin analogs has been demonstrated to be cost-effective versus other options over time and is an appropriate investment of healthcare dollars.
Brixner
Diana I
DI
Outcomes Research Center, University of Utah, Salt Lake City, UT 84108, USA. diana.brixner@pharm.utha.edu
McAdam-Marx
Carrie
C
D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000191:economics; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics; D017850:Economics, Pharmaceutical; D006801:Humans; D007328:Insulin / Q000031:analogs & derivatives* / Q000191:economics* / Q000627:therapeutic use; D018803:Models, Economic
D007328:Insulin