Cost-Effectiveness of Switching to Biphasic Insulin Aspart 30 from Human Insulin in Patients with Poorly ControlledType 2 Diabetes in South Koreavhe_628

Objectives: To estimate the cost-effectiveness of switching patients with poorly controlled type 2 diabetes mellitus from human insulin (HI) to biphasic insulin aspart 30 (BIAsp 30) in South Korea. Methods: A published and validated diabetes computer simulation model (the IMS CORE Diabetes Model) was used to evaluate the long-term clinical and economic outcomes associated with switching to BIAsp 30, using treatment effects from the South Korean subgroup of the Physician’s Routine Evaluation of Safety and Efficacy of NovoMix® 30 Therapy study and cost data collected through primary research. Outcomes included life expectancy, quality-adjusted life expectancy, incidence of complications, direct medical costs, and costeffectiveness. Analyses were performed from a third-party payer perspective over a 30-year time horizon. Future costs and clinical benefits were discounted at 5% per annum. Extensive sensitivity analyses were performed. Results: Switching patients uncontrolled on HI to BIAsp 30 was projected to increase discounted mean life expectancy by 0.15 0.18 years per patient (8.62 0.13 years vs. 8.47 0.13 years) and improve discounted mean quality-adjusted life expectancy by 0.30 0.12 quality-adjusted life-years (QALYs) per patient (5.68 0.09 QALYs vs. 5.38 0.09 QALYs). Conversion to BIAsp 30 was associated with a mean increase in direct costs of South Korean Won (KRW) 1,777,323 359,209 over patient lifetimes. BIAsp 30 was associated with an incremental costeffectiveness ratio of KRW5,916,758 per QALY gained versus HI. Conclusion: Switching patients uncontrolled on HI to BIAsp 30 was projected to improve life expectancy and quality-adjusted life expectancy. This analysis suggests that BIAsp 30 could be a cost-effective treatment option in type 2 diabetes patients poorly controlled on HI in South Korea.