Cost-effectiveness Study in Type 2 Diabetes Mellitus in Asia: A Review

https://doi.org/10.22146/jmpf.92720

I Made Wiracana(1), Nunung Priyatni(2), Dita Maria Virginia(3*)

(1) Student of Master Degree Program, Universitas Sanata Dharma, Yogyakarta
(2) Department of Pharmacy, Universitas Sanata Dharma, Yogyakarta
(3) Department of Pharmacy, Universitas Sanata Dharma, Yogyakarta
(*) Corresponding Author

Abstract


Background: Type 2 Diabetes Mellitus (DM) requires intensive treatment to prevent progression and complications. One of the intensive treatments is insulin therapy. The increase in insulin price and variation in insulin therapy results in differences in treatment costs. In Asia, commonly used types of insulin therapy are NPH insulin and glargine insulin. It is urgent to define the most cost-effective insulin therapy among type 2 DM patients because of the economic burden.

Objectives: This study aims to assess the cost-effectiveness of these insulin types. We did a narrative review using literature discussing the cost-effectiveness of insulin for type 2 DM patients.

Methods: This study employs a narrative review approach using the PRISMA-P 2015 structured approach to examine studies. This article's methodological quality was evaluated using the Drummond checklist. The terms "cost-effectiveness analysis," "diabetes mellitus type 2," and "insulin" were used in the literature search for this study.

Results: We obtained five pieces of literature fulfilling inclusion and exclusion criteria. The results indicated that the age range of type 2 DM patients in this study is 57-62 years, with a majority being women. The most frequently occurring complication is cardiovascular complications. NPH insulin and glargine insulin were the most extensively studied insulins in the literature review.

Conclusion: Based on the cost-effectiveness analysis, glargine insulin is more cost-effective than NPH insulin in Asia due to the rare occurrence of hypoglycemia which is a common side effect as a treatment outcomes.


Keywords


DM type 2; narrative review; cost effectiveness; Insulin NPH; Insulin glargine

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References

  1. Petersmann A, Nauck M, Müller-Wieland D, et al. Definition, classification and diagnostics of diabetes mellitus. J Lab Med. 2018;42(3):73-79. doi:10.1515/labmed-2018-0016
  2. Bullard KM, Cowie CC, Lessem SE, et al. Morbidity and Mortality Weekly Report Prevalence of Diagnosed Diabetes in Adults by Diabetes Type-United States, 2016. Morb Mortal Wkly Rep. 2016;67(12):2016-2018. doi:10.1097/EDE.0b013e31829ef01a
  3. Yan Y, Wu T, Zhang M, Li C, Liu Q, Li F. Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population. BMC Public Health. 2022;22(1):1-6. doi:10.1186/s12889-022-13759-9
  4. Hidayat B, Ramadani RV, Rudijanto A, Soewondo P, Suastika K, Siu Ng JY. Direct Medical Cost of Type 2 Diabetes Mellitus and Its Associated Complications in Indonesia. Value Heal Reg Issues. 2022;28:82-89. doi:10.1016/j.vhri.2021.04.006
  5. Suprapti B, Widyasari N, Rahmadi M, Wibisono C. Review of insulin therapy in type 2 diabetes mellitus ambulatory patients. Indones J Pharm. 2017;28(4):221-231. doi:10.14499/indonesianjpharm28iss4pp221
  6. Phulpagare MB, Tiwari SA, Hiray RS. Cost Excursion Study of Various Insulin Preparations Available in India. J Clin Diagnostic Res. Published online 2021:3-7. doi:10.7860/jcdr/2021/48116.15107
  7. Anggriani Y, Rianti A, Pratiwi AN, Khairani S. Evaluasi Biaya Pengobatan Pada Pasien Diabetes Melitus Tipe 2 Rawat Jalan dengan Terapi Insulin di RSUP X di Jakarta Periode Januari 2016-Desember 2017 Treatment Cost Evaluation of Type 2 Diabetes Mellitus Outpatient Patients Receiving Insulin Therapy at. Pharm J Indones. 2018;4(2):91-97.
  8. Zargar AH, Kalra S, K M PK, et al. Rising cost of insulin: A deterrent to compliance in patients with diabetes mellitus. Diabetes Metab Syndr Clin Res Rev. 2022;16(8):102528. doi:10.1016/j.dsx.2022.102528
  9. Fitriyani F, Andrajati R, Trisna Y. Analisis Efektivitas-Biaya Terapi Kombinasi Metformin-Insulin dan Metformin-Sulfonilurea pada Pasien Rawat Jalan dengan Diabetes Melitus Tipe 2 di RSUPN Dr. Cipto Mangunkusumo. Indones J Clin Pharm. 2021;10(1):10. doi:10.15416/ijcp.2021.10.1.10
  10. Liu G, Wu EQ, Ahn J, Kamae I, Xie J, Yang H. The Development of Health Technology Assessment in Asia: Current Status and Future Trends. Value Heal Reg Issues. 2020;21:39-44. doi:10.1016/j.vhri.2019.08.472
  11. Laelasari E, Sauriasari R, Banun A. Cost-effectiveness analysis of insulin, sulfonylurea, and sulfonylurea– Metformin in type 2 diabetes mellitus. Asian J Pharm Clin Res. 2017;10(Special Issue October):50-53. doi:10.22159/ajpcr.2017.v10s5.23094
  12. Thomas D, Hiligsmann M, John D, Al Ahdab OG, Li H. Pharmacoeconomic Analyses and Modeling. Elsevier Inc.; 2018. doi:10.1016/B978-0-12-814276-9.00018-0
  13. Drummond M., Jefferson T.O. Guideline for Authors and Peer Reviewers of Economic Submissions to the BMJ. BMJ. 1996;313(2):275-283.
  14. Permsuwan U, Chaiyakunapruk N, Dilokthornsakul P, Thavorn K, Saokaew S. Long-Term Cost-Effectiveness of Insulin Glargine Versus Neutral Protamine Hagedorn Insulin for Type 2 Diabetes in Thailand. Appl Health Econ Health Policy. 2016;14(3):281-292. doi:10.1007/s40258-016-0228-3
  15. Chan SP, Aamir AH, Bee YM, et al. Practical Guidance on Basal Insulin Initiation and Titration in Asia: A Delphi-Based Consensus. Diabetes Ther. 2022;13(8):1511-1529. doi:10.1007/s13300-022-01286-0
  16. Nugroho PS, Wijayanti AC. Indeks Masa Tubuh Dan Kaitannya Dengan Diabetes Melitus Pada Umur > 15 Tahun Di Indonesia, Studi Data Survei Kehidupan Keluarga Indonesia V. J Publ Kesehat Masy Indones. 2018;5(1):12. doi:10.20527/jpkmi.v5i1.4998
  17. Setiawan D, Endarti D, Suwantika A. Farmakoekonomi Modeling. UM Purwokerto Press; 2017.
  18. Permsuwan U, Thavorn K, Dilokthornsakul P, Saokaew S, Chaiyakunapruk N. Cost-effectiveness of insulin detemir versus insulin glargine for Thai type 2 diabetes from a payer’s perspective. J Med Econ. 2017;20(9):991-999. doi:10.1080/13696998.2017.1347792
  19. Chen Y, Zhang XP, Yuan J, et al. Association of body mass index and age with incident diabetes in Chinese adults: A population-based cohort study. BMJ Open. 2018;8(9):1-9. doi:10.1136/bmjopen-2018-021768
  20. Leon BM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6(13):1246. doi:10.4239/wjd.v6.i13.1246
  21. University of Oxford, Diabetes Trials Unit, Health Economics Research Centre. UKPDS Outcomes Model User Manual. 2015;(May):1-10. http://www.dtu.ox.ac.uk/outcomesmodel/UKPDSOutcomesManual.pdf
  22. Shafie AA, Ng CH. Cost-effectiveness of insulin glargine and insulin detemir in the basal regimen for naïve insulin patients with type 2 diabetes mellitus (T2dm) in malaysia. Clin Outcomes Res. 2020;12:333-343. doi:10.2147/CEOR.S244884
  23. Khairunnisa, Rawitri K, Wiryanto, Wahyuni S. Pengaruh Asuhan Kefarmasian Terhadap Outcome Klinis Dan Kualitas Hidup Pada Pasien Diabetes Melitus Tipe 2. JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X. 2021;13(2):118-128. doi:10.35617/jfionline.v13i2.18
  24. Farshchi A, Aghili R, Oskuee M, et al. Biphasic insulin Aspart 30 vs. NPH plus regular human insulin in type 2 diabetes patients; a cost-effectiveness study. BMC Endocr Disord. 2016;16(1):1-9. doi:10.1186/s12902-016-0116-8
  25. Lau E, Salem A, Chan JCN, et al. Insulin glargine compared to neutral protamine Hagedorn (NPH) insulin in patients with type-2 diabetes uncontrolled with oral anti-diabetic agents alone in Hong Kong: A cost-effectiveness analysis. Cost Eff Resour Alloc. 2019;17(1):1-13. doi:10.1186/s12962-019-0180-9
  26. McEwan P, Foos V, Palmer JL, Lamotte M, Lloyd A, Grant D. Validation of the IMS CORE diabetes model. Value Heal. 2014;17(6):714-724. doi:10.1016/j.jval.2014.07.007
  27. RI KK. Pedoman Teknis Analisis Farmakoekonomi Di Fasilitas Kesehatan.; 2016. doi:10.1088/1751-8113/44/8/085201
  28. PERKENI. Pedoman Petunjuk Praktis Terapi Insulin Pada Pasien Diabetes Mellitus 2021. Pb Perkeni. Published online 2021:32-39.
  29. Hirose T, Chen CC, Ahn KJ, Kiljański J. Use of Insulin Glargine 100 U/mL for the Treatment of Type 2 Diabetes Mellitus in East Asians: A Review. Diabetes Ther. 2019;10(3):805-833. doi:10.1007/s13300-019-0613-7
  30. Wang L, Wei W, Miao R, Xie L, Baser O. Real-world outcomes of US employees with type 2 diabetes mellitus treated with insulin glargine or neutral protamine Hagedorn insulin: A comparative retrospective database study. BMJ Open. 2013;3(4):1-9. doi:10.1136/bmjopen-2012-002348
  31. Rosenstock J, Fonseca V, Schinzel S, Dain MP, Mullins P, Riddle M. Reduced risk of hypoglycemia with once-daily glargine versus twice-daily NPH and number needed to harm with NPH to demonstrate the risk of one additional hypoglycemic event in type 2 diabetes: Evidence from a long-term controlled trial. J Diabetes Complications. 2014;28(5):742-749. doi:10.1016/j.jdiacomp.2014.04.003
  32. Joseph JJ, Donner TW. Long-term insulin glargine therapy in type 2 diabetes mellitus: A focus on cardiovascular outcomes. Vasc Health Risk Manag. 2015;11:107-116. doi:10.2147/VHRM.S50286
  33. Wolnik B, Wiza D, Szczepanik T, Syta A, Klupa T. Switching from Neutral Protamine Hagedorn Insulin to Insulin Glargine 300 U/mL Improves Glycaemic Control and Reduces Hypoglycaemia Risk: Results of a Multicentre, Prospective, Observational Study. J Diabetes Res. 2020;2020:0-7. doi:10.1155/2020/8751348
  34. Bonadonna RC, Mauricio D, Müller-Wieland D, et al. Impact of Age on the Effectiveness and Safety of Insulin Glargine 300 U/mL: Results from the REALI European Pooled Data Analysis. Diabetes Ther. 2021;12(4):1073-1097. doi:10.1007/s13300-021-01030-0



DOI: https://doi.org/10.22146/jmpf.92720

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