title: Therapy conversion to biphasic insulin aspart 30 improves long-term outcomes and reduces the costs of type 2 diabetes in Saudi Arabia.
abstract: OBJECTIVE
  An observational study in Saudi Arabia indicated that conversion to biphasic insulin aspart 30 (BIAsp 30) from human insulin (HI) was associated with improvement of glycaemic control.
  
  
  METHODS
  A validated computer simulation model of diabetes was used to project long-term outcomes (such as quality-adjusted life expectancy and direct medical costs) based on patient characteristics and treatment effects observed in the Saudi Arabian PRESENT subgroup (n=598). Baseline prevalence of comorbidities was obtained from published sources. Primary research was performed in Riyadh and Jeddah to derive diabetes-related complication costs and patient management practices.
  
  
  RESULTS
  Conversion to BIAsp 30 from HI was projected to increase life expectancy by 0.62 years (11.77 +/- 0.20 vs. 11.15 +/- 0.19 years) and quality-adjusted life expectancy by 0.96 quality-adjusted life years (QALYs) (7.03 +/- 0.12 vs. 6.07 +/- 0.11 QALYs). Direct medical cost savings of Saudi Arabian Riyals (SAR) 53,879 per patient were projected for conversion to BIAsp 30 therapy (SAR 84,761 +/- 3102 vs. SAR 138,640 +/- 4102 per patient). Cost savings were driven by lower costs of hypoglycaemia (SAR 286 vs. SAR 57,437 per patient), and lower costs of renal complications (SAR 18,848 vs. SAR 31,228) over patient lifetimes.
  
  
  CONCLUSIONS
  Conversion to BIAsp 30 from HI was projected to improve life expectancy and quality-adjusted life expectancy while reducing lifetime direct medical costs.
authors.affiliation: IMS Health, Riyadh, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ali
authors.forename: Jeremy
authors.initials: J
authors.lastname: White
authors.forename: Chen-Hui
authors.initials: CH
authors.lastname: Lee
authors.forename: James L
authors.initials: JL
authors.lastname: Palmer
authors.forename: Jayne
authors.initials: J
authors.lastname: Smith-Palmer
authors.forename: Walid
authors.initials: W
authors.lastname: Fakhoury
authors.forename: William J
authors.initials: WJ
authors.lastname: Valentine
mesh_terms: D000328:Adult; D061265:Biphasic Insulins; D003198:Computer Simulation; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics*; D038321:Glycemic Index / Q000187:drug effects; D017048:Health Care Costs; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D061267:Insulin Aspart; D007336:Insulin, Isophane; D008017:Life Expectancy; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012529:Saudi Arabia / Q000453:epidemiology; D012680:Sensitivity and Specificity
chemical_list: D061265:Biphasic Insulins; D007004:Hypoglycemic Agents; D007328:Insulin; C557564:insulin aspart, insulin aspart protamine drug combination 30:70; D007336:Insulin, Isophane; D061267:Insulin Aspart