OBJECTIVES: Previous real-world evidence (RWE) studies have demonstrated lower healthcare resource utilization (HCRU) in Type II diabetes (T2DM) patients who switched from 1^st generation to 2^nd generation basal insulin (BI) therapies. This study assessed the value and affordability of Gla-300 in a value-based economic model by leveraging the RWE from a U.S. payer perspective.

METHODS: An economic model for a hypothetical US health-plan was developed to assess the budgetary impact of therapeutic interchanges in either direction between the two generations of BIs over a three-year time horizon. Treatment naïve, prevalent (on BI for minimum of one year), and switcher patients comprised the cumulative population of the model. The utilization of ten branded and biosimilar BIs was based on 2020 data. The 2018 DELIVER-2 and 2020 DELIVER-naïve studies provided HCRU parameters, and the baseline proportion of treatment naïve and prevalent patients were reflective of the 2019 LIGHTNING study. Per Patient Per Year (PPPY) cost was the sum of wholesale acquisition costs (WAC) and all-cause (including hypoglycemia and diabetes related) HCRU costs divided by number of patients. Model base case scenario assumed 1^st to 2^nd generation BI switch, 62.7% naïve patients at Year 0, and 23% of patients switching to insulin glargine biosimilars by Year 3.

RESULTS: The base case scenario costs were $10,173 PPPY in Year 3 for the cumulative population. When all patients switched to Gla-300, the costs in Year 3 were $8,296, which reflected $1,877 PPPY lower budget impact compared to the base case. A 2^nd generation to 1^st generation BI reversal scenario, however, demonstrated a budgetary increase of $911 PPPY over the model horizon.

CONCLUSIONS: The RWE-based model parameters highlighted the economic value of increased utilization of Gla-300 driven by the reduction in HCRU. Budgetary reductions were achieved by switching patients from 1^st generation BIs to Gla-300.