Cost of Severe Hypoglycemia and Budget Impact with Nasal Glucagon in Patients with Diabetes in Spain.

IF 2.8 3区医学 Q3 ENDOCRINOLOGY & METABOLISM Diabetes Therapy Pub Date : 2022-04-01 Epub Date: 2022-03-16 DOI:10.1007/s13300-022-01238-8

Beatrice Osumili, Esther Artime, Beth Mitchell, Miriam Rubio-de Santos, Silvia Díaz-Cerezo, Marga Giménez, Erik Spaepen, Helen Sharland, William J Valentine

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Abstract

Introduction: Severe hypoglycemic events (SHE) represent a clinical and economic burden in patients with diabetes. Nasal glucagon (NG) is a novel treatment for SHEs with similar efficacy, but with a usability advantage over injectable glucagon (IG) that may translate to improved economic outcomes. The economic implications of this usability advantage on SHE-related spending in Spain were explored in this analysis.

Methods: A cost-offset and budget impact analysis (BIA) was conducted using a decision tree model, adapted for the Spanish setting. The model calculated average costs per SHE over the SHE treatment pathway following a treatment attempt with IG or NG. Analyses were performed separately in three populations with insulin-treated diabetes: children and adolescents (4-17 years) with type 1 diabetes (T1D), adults with T1D and adults with type 2 diabetes (T2D), with respective population estimates applied in BIA. Treatment probabilities were assumed to be equal for IG and NG, except for treatment success following glucagon administration. Epidemiologic and cost data were obtained from Spanish-specific sources. BIA results were presented at a 3-year time horizon.

Results: On a per SHE level, NG was associated with lower costs compared to IG (children and adolescents with T1D, EUR 820; adults with T1D, EUR 804; adults with T2D, EUR 725). Lower costs were attributed to reduced costs of professional medical assistance in patients treated with NG. After 3 years, BIA showed that relative to IG, the introduction of NG was projected to reduce SHE-related spending by EUR 1,158,969, EUR 142,162,371, and EUR 6,542,585 in children and adolescents with T1D, adults with T1D, and adults with insulin-treated T2D, respectively.

Conclusions: In Spain, the usability advantage of NG over IG translates to potential cost savings per SHE in three populations with insulin-treated diabetes, and the introduction of NG was associated with a lower budget impact versus IG in each group.

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西班牙糖尿病患者严重低血糖的成本和鼻用胰高血糖素的预算影响

导言：严重低血糖事件（SHE）是糖尿病患者的临床和经济负担。鼻用胰高血糖素（NG）是一种治疗严重低血糖事件的新型疗法，与注射用胰高血糖素（IG）相比，具有疗效相似但使用方便的优势，可改善经济效益。本分析探讨了这种可用性优势对西班牙 SHE 相关支出的经济影响：方法：使用决策树模型进行了成本抵消和预算影响分析（BIA），该模型根据西班牙的情况进行了调整。该模型计算了在尝试使用 IG 或 NG 治疗后，在 SHE 治疗过程中每个 SHE 的平均成本。对三种接受过胰岛素治疗的糖尿病人群分别进行了分析：1 型糖尿病（T1D）儿童和青少年（4-17 岁）、T1D 成人和 2 型糖尿病（T2D）成人，并在 BIA 中应用了各自的人群估计值。假定 IG 和 NG 的治疗概率相同，但胰高血糖素给药后的治疗成功率除外。流行病学数据和成本数据均来自西班牙特定来源。BIA 结果以 3 年为时间跨度：结果：在每个 SHE 水平上，NG 的成本低于 IG（T1D 儿童和青少年患者，820 欧元；T1D 成人患者，804 欧元；T2D 成人患者，725 欧元）。费用降低的原因是接受 NG 治疗的患者的专业医疗援助费用减少。3 年后，BIA 显示，与 IG 相比，在儿童和青少年 T1D 患者、成人 T1D 患者以及接受胰岛素治疗的成人 T2D 患者中，采用 NG 预计将分别减少 SHE 相关支出 1,158,969 欧元、142,162,371 欧元和 6,542,585 欧元：在西班牙，与 IG 相比，NG 的可用性优势可为三个接受胰岛素治疗的糖尿病人群节省每 SHE 的潜在成本，而且在每个组别中，采用 NG 对预算的影响都低于 IG。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

自引率

7.90%

发文量

130

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.