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Cost-utility analysis of insulin analogues compared with multiple daily injections of human insulin for the treatment of 15 years old or older patients with type 1 diabetes mellitus in Colombia

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dc.contributor.authorRosselli, Diego
dc.contributor.authorQuintian, Héctor
dc.contributor.authorGomez, Ana Maria
dc.contributor.authorGarcia Peña, A. A.
dc.contributor.authorArciniegas, J.
dc.contributor.authorIragorri, N.
dc.contributor.authorMantilla, B.
dc.contributor.authorGomez Restrepo, C.
dc.contributor.corporatenamePontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Grupo de Investigación de Enfermedades Crónicas del Adulto
dc.coverage.spatialColombiaspa
dc.date.accessioned2020-06-11T17:44:58Z
dc.date.available2020-06-11T17:44:58Z
dc.date.created2015-11-01
dc.description.abstractenglishInsulin analogues offer certain advantages over regular human insulin. Our objective was to establish the incremental cost-effectiveness ratio (ICER) of insulin analogues compared with human insulin, with multiple daily injections (MID) in adult patients with type 1 diabetes mellitus (DM1) in Colombia. We designed a Markov model of annual cycles, time horizon of up to 55 years, from a third-party payer perspective (only direct medical costs for the Colombian healthcare system) and applying discount rate of 3.5% both for costs and outcomes. Quality-adjusted life years (QALYs), taken from published literature, were used as a measure of effectiveness with a threshold of three times the per capita gross domestic product (GDP), approximately € 17,550. The comparison between analog and human insulin was performed separately for short and long term. The costs were in Colombian pesos (1 € = COP 2.660), and were built through base cases designed by interdisciplinary expert panels, with drug prices and costs of interventions or adverse events were estimated using official tariff manuals and databases. Univariate and probabilistic sensitivity analysis were performed. Despite certain clinical advantages, insulin analogues gain, on average, very few QALYs (from 0.02 to 0.1 depending on scenarios). With this result, the average ICER for short-term insulins would be € 78,900; while long duration insulin analogues have an ICER of € 94,550. Results were highly sensitive to price of medication, as well as to disutility or costs of hypoglycemic events. Given the assumptions and limitations of our model, insulin analogues would not be considered cost-effective within the Colombian healthcare system compared with multiple daily injections for adult patients with DM1.spa
dc.description.paginasA609-A609spa
dc.formatPDFspa
dc.format.mimetypeapplication/pdfspa
dc.format.soportePapel / Electrónicospa
dc.identifierhttps://www.valueinhealthjournal.com/article/S1098-3015(15)04184-4/fulltext?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1098301515041844%3Fshowall%3Dtruespa
dc.identifier.doihttps://doi.org/10.1016/j.jval.2015.09.2108spa
dc.identifier.issn1524-4733spa
dc.identifier.urihttp://hdl.handle.net/10554/49733
dc.languagespaspa
dc.rights.licenceAtribución-NoComercial 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.sourceValue in Health; Vol. 18 Núm. 7 (2015)spa
dc.titleCost-utility analysis of insulin analogues compared with multiple daily injections of human insulin for the treatment of 15 years old or older patients with type 1 diabetes mellitus in Colombiaspa
dc.typeinfo:eu-repo/semantics/article
dc.type.hasversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.localArtículo de revistaspa

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