Cost-effectiveness Analysis of Early Intervention with Insulin for Patients with Type 2 Diabetes Mellitus in Japan

Abstract

This study clarified the cost-effectiveness of early and short-term intervention with insulin as compared to oral anti-diabetic drugs for patients with type 2 diabetes mellitus in Japan. The lifetime costs and benefits of early intervention with insulin versus oral anti-diabetic drugs for patients with type 2 diabetes were evaluated by cost-effectiveness analysis conducted using the UKPDS outcome Model^©. The analysis was performed considering the payers’ perspective in Japanese medical settings. The parameters were obtained from the literature. Future costs and effectiveness were discounted by 2% per year. The expected lifetime costs for male and female diabetics of the insulin treatment group were JPY 3,095,631 (USD 25,927) and JPY 2,801,185 (USD 23,461), respectively, while those for male and female diabetics of the oral antidiabetic drug treatment group were JPY 3,086,926 (USD 25,584) and JPY 2,782,245 (USD 23,302), respectively. The expected life years was prolonged by 0.110 [95% CI: 0.032 to 0.189] and 0.074 [95% CI: 0.017 to 0.132], and the quality-adjusted life years increased by 0.059 [95% CI: 0.002 to 0.204] and 0.087 [95% CI: 0.039 to 0.135] in male and female patients, respectively, treated with insulin compared with OAD. Our results suggest that early and short-term intervention with insulin for type 2 diabetic patients was associated with an almost equivalent expected lifetime cost, prolonged expected life years, and increased the quality-adjusted life years as compared to that with oral antidiabetic drug treatment; early and short-term intervention with insulin was thus more cost-effective as compared to that with oral antidiabetic drugs.