ArticleFrontiers in public health2024
Budget impact analysis of insulin glargine vs. isophane protamine insulin treatment for patients with type-2 diabetes and severe hypoglycemia in Thailand.
Article in Frontiers in public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study aimed to assess the financial impact of different adoption rates of insulin glargine (IGlar) treatment compared to isophane protamine (neutral protamine hagedorn [NPH]) insulin treatment for patients with type-2 diabetes (T2D) and severe hypoglycemia in Thailand from the payer's perspective. Methods: The budget impact analysis (BIA) model over a period of 5 years was used to estimate the net budget impact (NBI) of IGlar treatment by comparing the total budget expenditures under two scenarios: scenario 1 involved only NPH insulin and scenario 2 included the introduction of IGlar. The total budget included either the cost of insulin or a combination of the costs of insulin and the expense related to severe hypoglycemia. Scenario 2 started at 20% uptake of IGlar and a yearly increase of 20%. NBI was calculated as the difference between the total budgets of scenarios 1 and 2. NBI and one-way sensitivity analyses were conducted for evaluation. Results: Considering only the cost of insulin, the use of IGlar for patients with T2D and severe hypoglycemia resulted in a yearly average NBI of 174.9 million Thai baht (THB) (5.1 million USD). However, when the cost related to severe hypoglycemia was included, the total budget incurred from scenario 2 was less than that of scenario 1, leading to a negative NBI or cost savings. Conclusion: The NBI of IGlar adoption would be substantial when considering only the cost of insulin; however, the significant benefit of IGlar in terms of a lower rate of severe hypoglycemia compared with NPH insulin would clearly offset the additional cost of IGlar.
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