Lays P Marra1, Vânia E Araújo1, Gerusa Cc Oliveira1, Leonardo M Diniz2, Augusto A Guerra Júnior1,3, Francisco de Assis Acurcio1,2,3, Brian Godman4,5,6, Juliana Álvares1,3. 1. Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil. 2. School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. 3. SUS Collaborating Centre - Technology Assessment & Excellence in Health, College of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil. 4. Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, UK. 5. Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden. 6. Health Economics Centre, Liverpool University Management School, Liverpool University, UK.
Abstract
AIM: Published studies have challenged the cost-effectiveness of insulin glargine versus neutral protamine hagedorn (NPH) insulins in Brazil with limited evidence of increased effectiveness despite considerably higher acquisition costs. However, still a controversy. Consequently, there is a need to address this. MATERIALS & METHODS: Retrospective cohort study of Type I diabetes patients receiving insulin glargine in Brazil following NPH insulin who met the criteria. RESULTS: 580 patients were enrolled. HbA1c varied from 8.80 ± 1.98% in NPH insulin users to 8.54 ± 1.88% after insulin glargine for 6 months, which is not clinically significant. Frequency of glycemic control varied from 22.6% with NPH insulin to 26.2% with insulin glargine. No statistically significant difference was observed between controlled and still uncontrolled groups for all analyzed factors including type and frequency of insulin use and carbohydrate counting. CONCLUSION: Limited differences between NPH insulins and insulin analogs in routine clinical care do not justify an appreciable cost difference.
AIM: Published studies have challenged the cost-effectiveness of insulinglargine versus neutral protamine hagedorn (NPH) insulins in Brazil with limited evidence of increased effectiveness despite considerably higher acquisition costs. However, still a controversy. Consequently, there is a need to address this. MATERIALS & METHODS: Retrospective cohort study of Type I diabetespatients receiving insulinglargine in Brazil following NPH insulin who met the criteria. RESULTS: 580 patients were enrolled. HbA1c varied from 8.80 ± 1.98% in NPH insulin users to 8.54 ± 1.88% after insulinglargine for 6 months, which is not clinically significant. Frequency of glycemic control varied from 22.6% with NPH insulin to 26.2% with insulinglargine. No statistically significant difference was observed between controlled and still uncontrolled groups for all analyzed factors including type and frequency of insulin use and carbohydrate counting. CONCLUSION: Limited differences between NPH insulins and insulin analogs in routine clinical care do not justify an appreciable cost difference.
Entities:
Keywords:
Brazil; NPH insulin; Type I diabetes; comparative effectiveness research; insulin glargine; longitudinal studies
Authors: Paulo H R F Almeida; Brian Godman; Vania Dos Santos Nunes-Nogueira; Lívia L P de Lemos; Francisco de Assis Acúrcio; Augusto A Guerra-Junior; Vânia E de Araújo; Alessandra M Almeida; Juliana Alvares-Teodoro Journal: Clin Diabetes Date: 2022
Authors: Marina Morgado Garcia; Pamela Santos Azevedo; Andrew Mirelman; Leandro Pinheiro Safatle; Roberto Iunes; Marion Clark Bennie; Brian Godman; Augusto Afonso Guerra Junior Journal: Front Pharmacol Date: 2020-04-14 Impact factor: 5.810
Authors: Paulo H R F Almeida; Thales B C Silva; Francisco de Assis Acurcio; Augusto A Guerra Júnior; Vania E Araújo; Leonardo M Diniz; Brian Godman; Alessandra M Almeida; Juliana Alvares Journal: Patient Date: 2018-08 Impact factor: 3.883
Authors: Thales B C Silva; Paulo H R F Almeida; Vania E Araújo; Francisco de Assis Acurcio; Augusto A Guerra Júnior; Brian Godman; Juliana Alvares Journal: Ther Adv Endocrinol Metab Date: 2018-06-22 Impact factor: 3.565