Health economic consequences of insulin analogues in the treatment of type 1 diabetes in Denmark

Introduction: Diabetes is a major challenge to the Danish health care system, and complications account for the majority of total treatment costs. Materials and methods: The majority of type 1 diabetes patients in Denmark are treated with the flexible basal-bolus insulin regimen. Use of insulin analogues provides superior metabolic control, lower blood glucose viability, flexible life style, reduced frequency of hypoglycaemia and no undesired weight gain. The long term health economic consequences were projected in a published and validated Markov model. Treatment effects of insulin analogues and a similar human insulin regimen were based on results from a clinical RCT study and Danish health care costs were applied in the model. Results: In the model, the improved glycaemic control and the reduction in hypoglycaemia episodes obtained with insulin analogues resulted in a reduction in late stage diabetes complications, improved quality of life and increased life expectancy compared to human insulin. The incremental costs-effectiveness ratio was estimated to DKK 55,867 per quality-adjusted life year gained, which is considered beneficial to society. Conclusion: Modelling predicts insulin analogues to be a cost-effective alternative to human insulin in Denmark.