Projecting the Long‐Term Cost‐Effectiveness of Once‐Weekly Insulin Icodec Versus Once‐Daily Basal Insulin Analogs in Italy Using the Prime T2D Model
Samuel J. P. Malkin, Saikrishna Kandalam, Giorgia Guareschi, Lucia S. D'Angiolella, Barnaby HuntABSTRACT
Background
Icodec is the first once‐weekly basal insulin for type 2 diabetes (T2D), potentially improving quality of life through a reduced administration burden versus once‐daily basal insulins. This study assessed the long‐term cost‐effectiveness of icodec versus glargine U100, degludec and a mix of once‐daily basal insulins (degludec, glargine U100 and glargine U300) in insulin‐naïve adults with T2D in Italy.
Methods
Outcomes were projected over patient lifetimes (up to 60 years) using the PRIME T2D Model, discounted annually at 3.0%. Baseline characteristics and treatment effects were taken from ONWARDS 1, 3 and 5. Modelled patients received basal insulins for 4 years, before intensifying with the addition of bolus insulin. Treatment effects applied in the first year of the analysis and a utility benefit relating to once‐weekly versus once‐daily injection were maintained until intensification. Costs were expressed in 2024 euros (EUR) from the perspective of the Italian National Health Service.
Results
Icodec was associated with improved quality‐adjusted life expectancy of 0.16 quality‐adjusted life years (QALYs) versus glargine U100 and degludec, and 0.26 QALYs versus the once‐daily insulin mix. Benefits primarily resulted from the reduced injection frequency with icodec. Higher acquisition costs with icodec were partially offset by reduced use of consumables and modelled reductions in diabetes‐related complications. Icodec was associated with incremental cost‐effectiveness ratios of EUR 25 623, EUR 5438 and EUR 3940 per QALY gained versus glargine U100, degludec and the once‐daily insulin mix, respectively.
Conclusions
Icodec was projected to be cost‐effective versus once‐daily insulins for insulin‐naïve people with T2D in Italy.