Projected long-term outcomes in patients with type 1 diabetes treated with fast-acting insulin aspart vs conventional insulin aspart in the UK setting

Diabetes Obes Metab. 2017 Dec;19(12):1773-1780. doi: 10.1111/dom.13026. Epub 2017 Jul 25.

Abstract

Aim: To assess the impact of faster aspart vs insulin aspart on long-term clinical outcomes and costs for patients with type 1 diabetes mellitus (T1DM) in the UK setting.

Methods: The QuintilesIMS CORE Diabetes Model was used to project clinical outcomes and costs over patient lifetimes in a cohort with data on baseline characteristics from the "onset 1" trial. Treatment effects were taken from the 26-week main phase of the onset 1 trial, with costs and utilities based on literature review. Future costs and clinical benefits were discounted at 3.5% annually.

Results: Projections indicated that faster aspart was associated with improved discounted quality-adjusted life expectancy (by 0.13 quality-adjusted life-years) vs insulin aspart. Improved clinical outcomes resulted from fewer diabetes-related complications and a delayed time to their onset with faster aspart. Faster aspart was found to be associated with reduced costs vs insulin aspart (cost savings of £1715), resulting from diabetes-related complications avoided and reduced treatment costs.

Conclusions: Faster aspart was associated with improved clinical outcomes and cost savings vs insulin aspart for patients with T1DM in the UK setting.

Keywords: cost-effectiveness; insulin therapy; type 1 diabetes.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / economics
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control
  • Cohort Studies
  • Cost of Illness*
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / economics
  • Direct Service Costs
  • Double-Blind Method
  • Drug Costs
  • Glycated Hemoglobin / analysis
  • Humans
  • Hyperglycemia / economics
  • Hyperglycemia / prevention & control
  • Hyperglycemia / therapy
  • Hypoglycemia / economics
  • Hypoglycemia / prevention & control
  • Hypoglycemia / therapy
  • Hypoglycemic Agents / economics
  • Hypoglycemic Agents / therapeutic use*
  • Incidence
  • Insulin Aspart / economics
  • Insulin Aspart / therapeutic use*
  • Insulin, Short-Acting / economics
  • Insulin, Short-Acting / therapeutic use*
  • Middle Aged
  • Models, Economic*
  • Quality of Life*
  • Risk
  • United Kingdom / epidemiology

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin, Short-Acting
  • hemoglobin A1c protein, human
  • Insulin Aspart