gms | German Medical Science

14. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

15.11. - 16.11.2007, Frankfurt am Main

Estimation of costs and long-term outcomes of the treatment with insulin glargine plus oral antidiabtics (BOT) compared to twice daily premixed insulin (CT) based on the LAPTOP Trial

Meeting Abstract

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  • corresponding author H. U. Janka - Klinikum Bremen Nord, Bremen, Germany
  • F. Hessel - Sanofi-Aventis Pharma GmbH, Berlin, Germany
  • E. Müller - Analytica International, Loerrach, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 14. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Frankfurt am Main, 15.-16.11.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gaa26

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gaa2007/07gaa26.shtml

Veröffentlicht: 12. November 2007

© 2007 Janka et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Context: The LAPTOP study, a randomized controlled clinical trial in insulin-dependent Type-II diabetes patients, showed clear advantages of a treatment regimen with insulin glargine plus oral antidiabetics (BOT) compared to twice daily premixed insulin (CT) with regard to HbA1c levels and nocturnal hypoglycemias over 24 weeks.

Aim of the study: Aim of the project was to estimate economic consequences and long-term outcomes based on the LAPTOP study.

Methods: A cost comparison analysis from a payer’s perspective based on the observed resource use for antidiabetic medical treatment, application aids, and blood sugar control materials was performed. Other resource uses were assumed to be either the same or not relevant. The costing was based on retail prices. Univariate sensitivity analyses were performed for all cost parameters. The clinical benefit expressed in HbA1c for long-term complications was estimated in a model simulation using the externally validated Diabetes-Mellitus-Model (DMM version 3.2).

Results: The mean annual cost for diabetes medication, application aids and blood sugar control materials were 1,259 € per patient with BOT respectively 1,495 € with CT. Annual Insulin consumption and prices had the highest impact on overall costs. The relative risk reduction (RRR) for micro and macro-vascular events after 10 simulation years was overall 6% in favour of BOT. RRR varied according to the type of complication between 11% (microvascular), 5% (retinopathy) and 2% (cardiovascular events and mortality).

Conclusion: Despite higher retail prices per insulin unit direct medical cost for relevant insulin treatment resource uses were lower for BOT vs. CT based on the results of the LAPTOP study. In addition the DMM simulation showed lower risks of long-term complications. Combining the results of the two analyses BOT can be regarded a dominant strategy over CT showing medical benefits and lower costs from German payer’s perspective.