Economic Evaluation of Once-Weekly Insulin Icodec from Italian NHS Perspective

Enrico Torre; Sergio Di Matteo; Giacomo Matteo Bruno; Chiara Martinotti; Luigi Carlo Bottaro; Giorgio Lorenzo Colombo

doi:10.2147/CEOR.S475461

Economic Evaluation of Once-Weekly Insulin Icodec from Italian NHS Perspective

Clinicoecon Outcomes Res. 2024 Nov 6:16:799-811. doi: 10.2147/CEOR.S475461. eCollection 2024.

Authors

Enrico Torre¹, Sergio Di Matteo², Giacomo Matteo Bruno³, Chiara Martinotti², Luigi Carlo Bottaro⁴, Giorgio Lorenzo Colombo³

Affiliations

¹ Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy.
² Center of Research, SAVE Studi - Health Economics and Outcomes Research, Milan, Italy.
³ Department of Drug Sciences, University of Pavia, Pavia, Italy.
⁴ General Direction, ASL3 -, Genoa, Italy.

Abstract

Background: Icodec, once-weekly basal insulin, aims to simplify therapy management by reducing injection frequency for diabetic patients. The efficacy and safety of icodec were evaluated in the ONWARDS clinical development program. This study evaluates icodec economic and quality of life impact from the Italian National Healthcare System (NHS) perspective.

Materials and methods: A pharmacoeconomic study was developed to assess the once-weekly insulin icodec value, highlighting its potential to decrease needle use while improving adherence and quality of life. In the base case, a differential cost and cost-utility analysis over one year compared to once-daily insulin degludec were developed. Based on the comparison with degludec, a scenario analysis was planned between icodec and the mix of basal insulins available on the market. Economic evaluations included drug and administration costs, needles, and impact on adherence. The cost-utility analysis measured the utility associated with the weekly injection compared to the daily ones, resulting in an incremental cost-effectiveness ratio (ICER), measured as Δ€/ΔQALY (Quality Adjusted Life Years). To assess the robustness of the results, a deterministic one-way sensitivity analysis and a probabilistic sensitivity analysis were carried out.

Results: At an annual cost 25% higher than degludec, considering the economic benefits generated by the needle use reduction (-€51.10) and adherence improvement (-€54.85), once-weekly icodec grants no incremental cost and even potential savings per patient. Furthermore, icodec reported a utility advantage (0.023). It achieved a dominant incremental cost-effectiveness ratio (ICER) compared to degludec. The comparison with the mix of basal insulins also reported a cost-effectiveness profile. Sensitivity tests conducted confirmed the robustness of the findings, highlighting the key drivers of the analysis.

Conclusion: Icodec represents a new therapeutic option to simplify basal insulin treatment. It also improves the patient's management and his quality of life, without increasing the economic burden for the Italian NHS, while guaranteeing an excellent cost-effectiveness profile.

Keywords: adherence improvement; cost-utility analysis; diabetes; differential cost analysis; icodec; once-weekly basal insulin.

Grants and funding

This study was funded by unconditional grant from NovoNordisk. The sponsors had no role in the design, execution, interpretation, or writing of the study.