Evidence map›Paper›PMID 29713962›Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2018

DEVOTE 5: Evaluating the Short-Term Cost-Utility of Insulin Degludec Versus Insulin Glargine U100 in Basal-Bolus Regimens for Type 2 Diabetes in the UK.

Richard F Pollock, William J Valentine, Steven P Marso, Jens Gundgaard, Nino Hallén, Lars L Hansen, Deniz Tutkunkardas, John B Buse, DEVOTE Study Group

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01959529 (A Trial Comparing Cardiovascular Safety of Insulin Degludec Versus Insulin Glargine in Subjects With Type 2 Diabetes at High Risk of Cardiovascular Events), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01959529 phase3completednot on this map

A Trial Comparing Cardiovascular Safety of Insulin Degludec Versus Insulin Glargine in Subjects With Type 2 Diabetes at High Risk of Cardiovascular Events

TypeinterventionalSponsorNovo Nordisk A/SRan2013 to 2016Enrolled7,637ConditionsDiabetes, Diabetes Mellitus, Type 2Armsinsulin degludec, insulin glargine
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 12 citations in OpenAlex.

  1. Trial
  2. Article
  3. Understanding the Clinical Profile of Insulin Degludec, the Latest Basal Insulin Approved for Use in Canada: a Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020
    Review
  4. Costs and where to find them: identifying unit costs for health economic evaluations of diabetes in France, Germany and Italy.The European journal of health economics : HEPAC : health economics in prevention and care · 2020
    Review
  5. Short-Term Cost-Effectiveness of Switching to Insulin Degludec in Japanese Patients with Type 2 Diabetes Receiving Basal-Bolus Therapy.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019
    Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Richard F PollockOssian Health Economics and Communications GmbH, Basel, Switzerland. pollock@ossianconsulting.com.
William J ValentineOssian Health Economics and Communications GmbH, Basel, Switzerland.
Steven P MarsoHCA Midwest Health Heart and Vascular Institute, Kansas City, MO, USA.
Jens GundgaardNovo Nordisk A/S, Søborg, Denmark.
Nino HallénNovo Nordisk A/S, Søborg, Denmark.
Lars L HansenNovo Nordisk A/S, Søborg, Denmark.
Deniz TutkunkardasNovo Nordisk A/S, Søborg, Denmark.
John B BuseUniversity of North Carolina School of Medicine, Medicine/Endocrinology, Chapel Hill, NC, USA.
DEVOTE Study Group
Novo Nordisk (Denmark) · DKHCA Midwest Division · USUniversity of North Carolina at Chapel Hill · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe aim of this study was to evaluate the short-term cost-utility of insulin degludec (degludec) versus insulin glargine 100 units/mL (glargine U100) for the treatment of type 2 diabetes in the basal-bolus subgroup of the head-to-head cardiovascular (CV) outcome trial, DEVOTE.

methodsA cost-utility analysis was conducted over a 2-year time horizon using a decision analytic model to compare costs in patients receiving once daily degludec or glargine U100, both as part of a basal-bolus regimen, in addition to standard care. Clinical outcomes and patient characteristics were taken exclusively from DEVOTE, whilst health-related quality of life utilities and UK-specific costs (expressed in 2016 GBP) were obtained from the literature. The analysis was conducted from the perspective of the National Health Service.

resultsDegludec was associated with mean cost savings of GBP 28.78 per patient relative to glargine U100 in patients with type 2 diabetes at high CV risk. Cost savings were driven by the reduction in risk of diabetes-related complications with degludec, which offset the higher treatment costs relative to glargine U100. Degludec was associated with a mean improvement of 0.0064 quality-adjusted life-years (QALYs) compared with glargine U100, with improvements driven predominantly by lower rates of severe hypoglycemia with degludec versus glargine U100. Improvements in quality-adjusted life expectancy combined with cost neutrality resulted in degludec being dominant over glargine U100. Sensitivity analyses demonstrated that the incremental cost-utility ratio was stable to variations in the majority of model inputs.

conclusionThe present short-term modeling analysis found that for the basal-bolus subgroup of patients in DEVOTE, with a high risk of CV events, degludec was cost neutral (no additional costs) compared with glargine U100 over a 2-year time horizon in the UK setting. Furthermore, there were QALY gains with degludec, particularly due to the reduction in the risk of severe hypoglycemia.

fundingNovo Nordisk A/S.

trial registrationClinicalTrials.gov identifier, NCT01959529.

Indexed as

Cardiovascular outcome trialCostCost-effectiveDiabetesHypoglycemiaInsulin degludecQALYUnited Kingdom

Identifiers

PMID29713962
PMCPMC5984933
OpenAlexW2801737090

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.