title: Cost-effectiveness of switching to biphasic insulin aspart 30 from human insulin in patients with poorly controlled type 2 diabetes in South Korea.
abstract: OBJECTIVE
  To estimate the cost-effectiveness of switching patients with poorly controlled type 2 diabetes mellitus from human insulin (HI) to biphasic insulin aspart 30 (BIAsp 30) in South Korea.
  
  
  METHODS
  A published and validated diabetes computer simulation model (the IMS CORE Diabetes Model) was used to evaluate the long-term clinical and economic outcomes associated with switching to BIAsp 30, using treatment effects from the South Korean subgroup of the Physician's Routine Evaluation of Safety and Efficacy of NovoMix 30 Therapy study and cost data collected through primary research. Outcomes included life expectancy, quality-adjusted life expectancy, incidence of complications, direct medical costs, and cost-effectiveness. Analyses were performed from a third-party payer perspective over a 30-year time horizon. Future costs and clinical benefits were discounted at 5% per annum. Extensive sensitivity analyses were performed.
  
  
  RESULTS
  Switching patients uncontrolled on HI to BIAsp 30 was projected to increase discounted mean life expectancy by 0.15 +/- 0.18 years per patient (8.62 +/- 0.13 years vs. 8.47 +/- 0.13 years) and improve discounted mean quality-adjusted life expectancy by 0.30 +/- 0.12 quality-adjusted life-years (QALYs) per patient (5.68 +/- 0.09 QALYs vs. 5.38 +/- 0.09 QALYs). Conversion to BIAsp 30 was associated with a mean increase in direct costs of South Korean Won (KRW) 1,777,323 +/- 359,209 over patient lifetimes. BIAsp 30 was associated with an incremental cost-effectiveness ratio of KRW5,916,758 per QALY gained versus HI.
  
  
  CONCLUSIONS
  Switching patients uncontrolled on HI to BIAsp 30 was projected to improve life expectancy and quality-adjusted life expectancy. This analysis suggests that BIAsp 30 could be a cost-effective treatment option in type 2 diabetes patients poorly controlled on HI in South Korea.
authors.affiliation: IMS Health, Seoul, South Korea.
authors.forename: Kyoung Hee
authors.initials: KH
authors.lastname: Lee
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Seo
authors.forename: Jayne
authors.initials: J
authors.lastname: Smith-Palmer
authors.forename: James L
authors.initials: JL
authors.lastname: Palmer
authors.forename: Jeremy
authors.initials: J
authors.lastname: White
authors.forename: William J
authors.initials: WJ
authors.lastname: Valentine
mesh_terms: D000328:Adult; D000368:Aged; D061265:Biphasic Insulins; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000191:economics*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use; D007328:Insulin / Q000031:analogs & derivatives* / Q000191:economics* / Q000627:therapeutic use; D061267:Insulin Aspart; D007336:Insulin, Isophane; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D056910:Republic of Korea
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