Cost-effectiveness analysis of switch from premix human insulin to biphasic insulin aspart 30 in Chinese patients with type 2 diabetes mellitus

Objective To evaluate cost-effectiveness of switching from human premix insulin to biphasic insulin aspart (BIAsp 30) in patients with type 2 diabetes mellitus (T2DM) in China, in the short term and long term respectively. Methods The cost-effectiveness analysis was based on clinical data of A1chieve®China subgroup and published cost data in China from November 2008 to March 2011. For the short-term analysis, effectiveness derived from quality of life data at baseline and end of study, and total cost includes cost for insulin and hypoglycemic events. For the long-term, CORE diabetes model was used to project life expectancy, quality-adjusted life years (QALYs) and total direct medical costs over 30 years from a societal perspective. Patient characteristics and treatment effects were obtained from Chinese subgroup in the A1chieve® study. Total costs included insulin cost, management and complication costs. One-way sensitivity analysis was performed. Results After 24-week treatment with BIAsp 30 from human premix insulin, EQ-5D utility value increased for 0.034, and total costs decreased for CNY 749.13. When projecting for 30 years, treatment with BIAsp 30 from human premix insulin increased life expectancy by 0.686 year and improved quality-adjusted life years by 1.958 QALYs per patient, total direct medical cost reduced by CNY 70 252. Sensitivity analyses demonstrated robustness of the results. Conclusions Switching to BIAsp 30 from human premix insulin is associated with improvements in life expectancy and QALYs, and is a cost-saving treatment strategy for people with T2DM in China. Key words: Diabetes mellitus, type 2; Biphasic insulin aspart 30; Cost-effectiveness analysis; CORE diabetes model