Pharmacoeconomic simulation of delayed results of the treatment of type 2 diabetes mellitus with modern insulin analogsin comparison with oral hypoglycemic agents

Abstract

Aim. To carry out cost-effectiveness analysis of treatment options for type 2 diabetes using different groups of medicines, to prognosticate late diabeticcomplications and the cost of their management. Materials and methods. A total of 3678 DM2 patients (with mean HbAc1 level 9.3%) were examined in 23 regionsin the framework of the Diabetesmellitus subprogram of the Federal target program "Prevention and control of socially significant diseases". Two hypothetical therapeutic modalitieswere considered: treatment with NovoMix 30 and oral hypoglycemic (OHG) agents. The CORE model was used to analyse anticipated expendituresand DM outcomes. Results. Simulation revealed a greater decrease of HbA1c levels (-1.7%), reduction of total cholesterol, LDL, systolic AP (-4.1%) and risk of cardiovasculardiseases coupled to increase of HDL in patients treated with NovoMix 30. Maximum life expectancy was 17.2 yr compared with 16.5 yrin the OHG group and overall cost of the treatment 1,650,725 and 1,586,234 rubles respectively. Savings for the treatment of diabetes using NovoMix30 amounted to 19,832 rubles per patients due to reduced indirect expenditures including management of renal, cardiac, ophthalmologic , and cerebrovascularcomplications. Conclusion. Simulation of late results of DM2 treatment demonstrated enhanced pharmacoeconomic efficiency of modern insulin analogs comparedwith OHG agents.