Economic Impact of Therapeutic Choices: The Case of Incretins

The objective of this economic evaluation was to compare two alternative therapeutic regimens for the treatment of type 2 diabetes: basal-bolus insulin vs basal insulin and DPP-4. We conducted a Cost-Minimization Analysis (CMA) to compare the annual cost of basal-bolus insulin regimen vs basal insulin and DPP-4 regimen from the perspective of the Italian National Health Service (NHS). The CMA considered only direct medical costs (basal insulin, bolus insulin and DPP-4 [sitagliptin] and self-monitoring of glycemic control). Costs were assessed in 2014 Euros. Sensitivity analysis and threshold analysis on key economic parameters were performed. The expected annual cost (per patient) was €987.60 with basal insulin and DPP-4 and €1,568.23 with basal-bolus insulin. As a consequence of a significant reduction of glycemic control costs, the regimen with DPP-4 was a cost-saving alternative from the perspective of the Italian NHS.