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COST-EFFECTIVENESS ANALYSIS OF LONG-ACTING INSULIN ANALOGS IN TYPE 2 DIABETES MELLITUS TREATMENT IN VIETNAM USING MARKOV MODEL
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Abstract
Background and Objectives: Type 2 diabetes mellitus (T2DM) is one major public health problem in the world and in Vietnam, due to high prevalence with increasing trend in recent years, negative impact on socioeconomic and patient’s health. Long-acting basal insulin analog is one of the treatment options for T2DM in Vietnam and there are 2 insulin available: insulin glargine (IGlar) and insulin detemir (IDet). This study was conducted to assess the cost-effectiveness of IGlar compared to IDet based on available literature. Methods: A Markov model was developed, stimulate the transition of 1000 patients from 6 different health states: No complication, Myocardial infarction, Stroke, Peripheral diseases, Microvascular diseases and Dead. The model present costs and utilities relating to diabetic complications and insulin usage over the horizon of 40 years, and model cycle is 1 year. Cost-effectiveness analysis was conducted from societal perspective. One-way sensitivity analysis was also performed. Results: Using IGlar in treating T2DM in Vietnam results in a lower cost (saving VND 26,288,432,135) and a higher utility (increase 210.945 QALYs) compared to IDet. Sensitivity analysis showed that incremental costs and utilities depend largely on assumptions about average insulin dose and T2DM complications risks. However, the conclusion about IGlar cost-effectiveness was not altered. Conclusions: The study provided evidence on the dominant cost-effectiveness of IGlar compared to IDet in treating T2DM in Vietnam.
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Keywords
Type 2 diabetes mellitus, insulin glargine, insulin detemir, cost-effectiveness
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