Cost-effectiveness of insulin analogs from the perspective of the Brazilian public health system
Braz. J. Pharm. Sci. (Online)
;
53(3): e00178, 2017. tab, graf
Article
in English
| LILACS
| ID: biblio-889385
ABSTRACT
ABSTRACT Human insulin is provided by the Brazilian Public Health System (BPHS) for the treatment of diabetes, however, legal proceedings to acquire insulin analogs have burdened the BPHS health system. The aim of this study was to perform a cost-effectiveness analysis to compare insulin analogs and human insulins. This is a pharmacoeconomic study of cost-effectiveness. The direct medical cost related to insulin extracted from the Ministry of Health drug price list was considered. The clinical results, i.e. reduction in glycated hemoglobin (HbA1c), were extracted by meta-analysis. Different scenarios were structured to measure the uncertainties regarding the costs and reduction in HbA1c. Decision tree was developed for sensitivity of Incremental Cost Effectiveness Ratio (ICER). A total of fifteen scenarios were structured. Given the best-case scenario for the insulin analogs, the insulins aspart, lispro, glargine and detemir showed an ICER of R$ 1,768.59; R$ 3,308.54; R$ 11,718.75 and R$ 2,685.22, respectively. In all scenarios in which the minimum effectiveness was proposed, lispro, glargine and detemir were dominant strategies. Sensitivity analysis showed that the aspart had R$ 3,066.98 [95 % CI 2339.22; 4418.53] and detemir had R$ 6,163.97 [95% CI 3919.29; 11401.57] for incremental costs. We concluded there was evidence that the insulin aspart is the most cost-effective.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Cost-Benefit Analysis
/
Insulin, Long-Acting
/
Insulins
/
Insulin, Short-Acting
Type of study:
Health economic evaluation
/
Prognostic study
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Braz. J. Pharm. Sci. (Online)
Journal subject:
Farmacologia
/
Teraputica
/
Toxicologia
Year:
2017
Type:
Article
/
Project document
Affiliation country:
Brazil
Institution/Affiliation country:
Federal University of Espirito Santo/BR
/
University of São Paulo/BR
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