title: An analysis of the cost-effectiveness of switching from biphasic human insulin 30, insulin glargine, or neutral protamine Hagedorn to biphasic insulin aspart 30 in people with type 2 diabetes.
abstract: OBJECTIVE
  The aim of this analysis was to assess the cost-effectiveness of switching from biphasic human insulin 30 (BHI), insulin glargine (IGlar), or neutral protamine Hagedorn (NPH) insulin (all ± oral glucose-lowering drugs [OGLDs]) to biphasic insulin aspart 30 (BIAsp 30) in people with type 2 diabetes in India, Indonesia, and Saudi Arabia.
  
  
  METHODS
  The IMS CORE Diabetes Model was used to determine the clinical outcome, costs, and cost-effectiveness of switching from treatment with BHI, IGlar, or NPH to BIAsp 30 over a 30-year time horizon. A 1-year analysis was also performed based on quality-of-life data and treatment costs. Incremental cost-effectiveness ratios (ICERs) were expressed as a fraction of gross domestic product (GDP) per capita, and cost-effectiveness was defined as ICER <3-times GDP per capita.
  
  
  RESULTS
  Switching treatment from BHI, IGlar, or NPH to BIAsp 30 was associated with an increase in life expectancy of >0.7 years, reduction in all diabetes-related complications, and was considered as cost-effective or highly cost-effective in India, Indonesia, and Saudi Arabia (BHI to BIAsp 30, 0.26 in India, 1.25 in Indonesia, 0.01 in Saudi Arabia; IGlar to BIAsp 30, -0.68 in India, -0.21 in Saudi Arabia; NPH to BIAsp 30, 0.15 in India, -0.07 in Saudi Arabia; GDP per head per annum/quality-adjusted life-year). Cost-effectiveness was maintained in the 1-year analyses.
  
  
  CONCLUSIONS
  Switching from treatment with BHI, IGlar, or NPH to BIAsp 30 (all ± OGLDs) was found to be cost-effective in India, Indonesia, and Saudi Arabia, both in the long and short term.
authors.affiliation: Jaslok Hospital and Research Centre , Mumbai , India.
authors.forename: Vishal
authors.initials: V
authors.lastname: Gupta
authors.forename: Ranya
authors.initials: R
authors.lastname: Baabbad
authors.forename: Eva
authors.initials: E
authors.lastname: Hammerby
authors.forename: Annie
authors.initials: A
authors.lastname: Nikolajsen
authors.forename: Asrul Akmal
authors.initials: AA
authors.lastname: Shafie
mesh_terms: D000368:Aged; D061265:Biphasic Insulins / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D048909:Diabetes Complications / Q000191:economics* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000191:economics*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000145:classification / Q000191:economics / Q000627:therapeutic use; D015994:Incidence; D007194:India / Q000453:epidemiology; D007214:Indonesia / Q000453:epidemiology; D061267:Insulin Aspart / Q000191:economics / Q000627:therapeutic use; D000069036:Insulin Glargine / Q000191:economics / Q000627:therapeutic use; D007336:Insulin, Isophane / Q000191:economics / Q000627:therapeutic use; D061385:Insulins / Q000145:classification / Q000191:economics* / Q000627:therapeutic use; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012529:Saudi Arabia / Q000453:epidemiology
chemical_list: D061265:Biphasic Insulins; D004338:Drug Combinations; D007004:Hypoglycemic Agents; D061385:Insulins; C575870:biphasic human insulin 30; C557564:insulin aspart, insulin aspart protamine drug combination 30:70; D000069036:Insulin Glargine; D007336:Insulin, Isophane; D061267:Insulin Aspart
keywords: A1chieve; Biphasic insulin aspart 30; Cost-effectiveness; India; Indonesia; Saudi Arabia; Type 2 diabetes mellitus