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Systematic review of the cost-effectiveness of biphasic insulin aspart 30 in type 2 diabetes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Valentine, William J. Pollock, Richard F. Plun-Favreau, Juliette White, Jeremy
Description	Country affiliation: Switzerland Author Affiliation: Valentine WJ ( Ossian Health Economics and Communications, Basel, Switzerland. valentine@ossianconsulting.com)
Abstract	OBJECTIVES: To review the cost-effectiveness of biphasic insulin aspart (BIAsp 30) compared to other insulin regimens in the treatment of type 2 diabetes based on published literature. METHODS: The electronic databases MEDLINE, EMBASE, the Cochrane Library and EconLit and a selection of congress/meeting databases were systematically searched using combinations of search terms designed to identify publications describing cost-effectiveness analyses of BIAsp 30 in patients with type 2 diabetes. Searches were limited to studies in humans, and published in the English language between January 1999 and July 2009. All records were screened for inclusion in the review. RESULTS: Seven published cost-effectiveness analyses and ten abstracts were identified. One was a health technology assessment from the UK, which evaluated cost-effectiveness using the UKPDS Outcomes Model and meta-analysis of published clinical trials and concluded that premixed insulin analogs were unlikely to be cost-effective versus insulin glargine or biphasic human insulin. In all other studies the cost-effectiveness of BIAsp 30 versus other insulin regimens was assessed using the validated CORE Diabetes Model and outcomes from either the INITIATE randomized controlled trial, or the PRESENT or IMPROVE observational studies. However, notable limitations include the fact that all cost-effectiveness analyses to date have been performed using a single model and that a number of these are based on data from observational studies rather than randomized controlled trials. Nevertheless, long-term clinical and economic outcomes were reported for several countries: UK, US, Sweden, Saudi Arabia, Poland, South Africa, South Korea and China. BIAsp 30 was associated with improvements in quality-adjusted life expectancy in all countries. Estimates of direct costs varied according to country and comparator, but incremental cost-effectiveness ratios for the US and UK were USD 46 533 and GBP 6951 per quality-adjusted life year gained for BIAsp 30 versus insulin glargine. CONCLUSIONS: Although cost-effectiveness data on BIAsp 30 are scarce the majority of the analyses identified in this review suggest that BIAsp 30 is likely to be cost-effective compared to insulin glargine and biphasic human insulin across a wide range of settings, and under certain circumstances would be a dominant treatment option.
File Format	HTM / HTML
ISSN	03007995
Issue Number	6
Volume Number	26
e-ISSN	14734877
Journal	Current Medical Research and Opinion
Language	English
Publisher	Taylor & Francis
Publisher Date	2010-06-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Medicine Diabetes Mellitus, Type 2 Drug Therapy Hypoglycemic Agents Economics Insulin Analogs & Derivatives Biphasic Insulins Cost-benefit Analysis Humans Therapeutic Use Insulin Aspart Insulin, Isophane Middle Aged Comparative Study Journal Article Research Support, Non-u.s. Gov't Review
Content Type	Text
Resource Type	Article
Subject	Medicine

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Systematic review of the cost-effectiveness of biphasic insulin aspart 30 in type 2 diabetes.

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Systematic review of the cost-effectiveness of biphasic insulin aspart 30 in type 2 diabetes.