The Healthcare Resource Use Impact in Adults With Type 1 Diabetes Who Switched From a First to Another First or Next-Generation Basal Insulin Analogue: A Retrospective Linked Primary and Secondary Care Database Study in England

Author(s)

Diribe O1, Holden N2, Palmer K2, Puttanna A2, Mahieu A3, Nicholls C2, Marston X4, Denholm N5, Idris I6
1Sanofi, Reading, Berkshire, UK, 2Sanofi, Reading, UK, 3Sanofi, Paris, France, 4Open Health, London, LON, UK, 5OPEN Health, London, LON, UK, 6University of Nottingham, Nottingham, Nottingham, UK

OBJECTIVES: The real-world impact of the next-generation basal insulin (Glargine U300 [Gla-300], Degludec) on healthcare resource use and mortality has previously been demonstrated in Type 2 diabetes mellitus. This study aimed to examine this impact in English adults with Type 1 diabetes mellitus (T1DM) following a switch to Gla-300.

METHODS: CPRD-HES linked data were used to compare hospitalizations and mortality in an IPTW (inverse probability of treatment weighting)-weighted set of adults with T1DM who switched from glargine 100U/mL or detemir (collectively Gen1BI) to either another Gen1BI (Gen1 cohort) or Gla-300 (Gla-300 cohort). The date of the switch was defined as the index date.

RESULTS: The weighted (post-IPTW) cohorts included 3,926 patients (Gen1 cohort) and 1,674 (Gla-300 cohort). Overall hospitalization rates among the two cohorts were (Gen1 vs. Gla-300): all-cause, 2,165 (55.1%) vs. 587 (35.0%), p=<0.001; T1DM-associated, 890 (22.7%) vs. 223 (13.3%), p=<0.001; hypoglycemia-associated, 478 (12.2%) vs. 88 (5.2%), p=<0.001; DKA-associated, 447 (11.4%) vs. 110 (6.6%), p=<0.001, respectively. The mean (SD) hospitalizations were (Gen1 vs. Gla-300): all-cause, 1.45 (7.60) vs 0.91 (8.63), p=<0.001; T1DM- associated, 0.18 (0.81) vs 0.11 (0.50), p=<0.001; hypoglycemia-associated, 0.08 (0.48) vs 0.05 (0.37), p=0.002; DKA- associated, 0.07 (0.49) vs 0.05 (0.27), p=<0.001 per patient-year, respectively. Where hypoglycemia or DKA was the primary reason for hospitalization, the hospitalization rates were (Gen1 vs. Gla-300); hypoglycemia, 167 (4.2%) vs 17 (1.0%), p=<0.001; DKA, 372 (9.5%) vs 98 (5.9%) p=<0.001, respectively.

The all-cause mortality was 1.52 and 0.7 per 100 patient-years, respectively (p = <0.001).

CONCLUSIONS: The results showed that a switch to Gla-300 from a Gen1BI was associated with significantly reduced healthcare resource use and decreased risk of mortality, an overall benefit for people with TIDM. For the National Health System, this switch could result in considerable cost savings and more efficient allocation of healthcare resources, ultimately enhancing the overall management of T1DM.

Conference/Value in Health Info

2024-11, ISPOR Europe 2024, Barcelona, Spain

Value in Health, Volume 27, Issue 12, S2 (December 2024)

Code

EPH42

Topic

Clinical Outcomes, Economic Evaluation, Study Approaches

Topic Subcategory

Comparative Effectiveness or Efficacy, Cost-comparison, Effectiveness, Utility, Benefit Analysis, Electronic Medical & Health Records

Disease

Diabetes/Endocrine/Metabolic Disorders (including obesity), Drugs

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