An analysis of the cost-effectiveness of starting insulin detemir in insulin-naïve people with type 2 diabetes

Philip Home, Sei Hyun Baik, Guillermo González Gálvez, Rachid Malek, Annie Nikolajsen

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Aims: There is limited evidence with respect to the cost-effectiveness of starting insulin in people with diabetes outside the 'western' world. The aim of this study was to assess the cost-effectiveness of starting basal insulin treatment with insulin detemir in people with type 2 diabetes (T2D) inadequately controlled on oral glucose-lowering drugs (OGLDs) in Mexico, South Korea, India, Indonesia, and Algeria. Methods: The IMS CORE Diabetes Model was used to project clinical and cost outcomes over a 30-year time horizon. Clinical outcomes, baseline characteristics and health state utility data were taken from the A1chieve study. A 1-year analysis was also conducted based on treatment costs and quality-of-life data. Incremental cost-effectiveness ratios (ICERs) were expressed as a fraction of GDP per capita, and WHO-CHOICE recommendations (ICER<3.0) used to define cost-effectiveness. Results: Starting insulin detemir was associated with a projected increase in life expectancy (1 year) and was considered cost-effective in all of the studied populations with ICERs of -0.02 (Mexico), 0.00 (South Korea), 0.48 (India), 0.12 (Indonesia), and 0.88 (Algeria) GDP/quality-adjusted life-year. Cost-effectiveness was maintained after conducting sensitivity analyses in the 30-year and 1-year analyses. A projected increase in treatment costs was partially offset by a reduction in complications. The difference in overall costs between insulin detemir and OGLDs alone was USD518, 1431, 3510, 15, and 5219, respectively. Conclusion: Changes in clinical outcomes associated with starting insulin detemir in insulin-naïve individuals with T2D resulted in health gains that made the intervention cost-effective in five countries with distinct healthcare resources.

Original languageEnglish
Pages (from-to)230-240
Number of pages11
JournalJournal of Medical Economics
Issue number3
Publication statusPublished - 2015 Mar 1
Externally publishedYes

Bibliographical note

Funding Information:
This research was supported by Novo Nordisk.

Publisher Copyright:
© 2014 All rights reserved: reproduction in whole or part not permitted.


  • A1chieve
  • Cost-effectiveness
  • Insulin detemir
  • Type 2 diabetes

ASJC Scopus subject areas

  • Health Policy


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