Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Jun 9;16(1):35.
doi: 10.1186/s12902-016-0116-8.

Biphasic insulin Aspart 30 vs. NPH plus regular human insulin in type 2 diabetes patients; a cost-effectiveness study

Amir Farshchi  1 , Rokhsareh Aghili  2 , Maryam Oskuee  3 , Marjan Rashed  3 , Sina Noshad  4 , Abbas Kebriaeezadeh  1 , Maryam Kia  5 , Alireza Esteghamati  6
Affiliations
Randomized Controlled Trial

Biphasic insulin Aspart 30 vs. NPH plus regular human insulin in type 2 diabetes patients; a cost-effectiveness study

Amir Farshchi et al. BMC Endocr Disord. .

Abstract

Background: The aim of this study was to compare the efficacy, safety, costs, and cost-effectiveness of biphasic insulin aspart 30 (BIAsp 30) with NPH plus regular human insulin (NPH/Reg) in patients with type 2 diabetes mellitus (T2DM).

Methods: It was a Single-center, parallel-group, randomized, clinical trial (Trial Registration: NCT01889095). One hundred and seventy four T2DM patients with poorly controlled diabetes (HbA1c ≥ 8 % (63.9 mmol/mol)) were randomly assigned to trial arms (BIAsp 30 and NPH/Reg) and were followed up for 48 weeks. BIAsp 30 was started at an initial dose of 0.2-0.6 IU/Kg in two divided doses and was titrated according to the glycemic status of the patient. Similarly, NPH/Reg insulin was initiated at a dose of 0.2-0.6 IU/Kg with a 2:1 ratio and was subsequently titrated. Level of glycemic control, hypoglycemic events, direct and indirect costs, quality adjusted life year (QALY) and incremental cost-effectiveness ratio have been assessed.

Results: HbA1c, Fasting plasma glucose (FPG), and two-hour post-prandial glucose (PPG) were improved in both groups during the study (P < 0.05 for all analyses). Lower frequencies of minor, major, and nocturnal hypoglycemic episodes were observed with BIAsp 30 (P < 0.05). Additionally, BIAsp 30 was associated with less weight gain and also higher QALYs (P < 0.05). Total medical and non-medical costs were significantly lower with BIAsp 30 as compared with NPH/Reg (930.55 ± 81.43 USD vs. 1101.24 ± 165.49 USD, P = 0.004). Moreover, BIAsp 30 showed lower ICER as a dominant alternative.

Conclusions: Despite being more expensive, BIAsp 30 offers the same glycemic control as to NPH/Reg dose-dependently and also appears to cause fewer hypoglycemic events and to be more cost-effective in Iranian patients with type 2 diabetes.

Keywords: Biphasic insulin aspart 30; Cost; Cost-effectiveness and QALY; Insulin; Type 2 diabetes mellitus.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
CONSORT flow diagram
See this image and copyright information in PMC

References

    1. Aghili R, Khamseh ME, Malek M, Yarahmadi S, Farshchi A. Structured self monitoring of blood glucose in Iranian people with type 2 diabetes; A cost consequence analysis. Daru. 2012;20(1):32. doi: 10.1186/2008-2231-20-32. - DOI - PMC - PubMed
    1. Farshchi A, Esteghamati A, Sari AA, Kebriaeezadeh A, Abdollahi M, Dorkoosh FA, et al. The cost of diabetes chronic complications among Iranian people with type 2 diabetes mellitus. J Diabetes Metab Disorders. 2014;13(1):42. doi: 10.1186/2251-6581-13-42. - DOI - PMC - PubMed
    1. Farshchi A, Nikfar S, Abdollahi M. Concerns on the use of chromium in type 2 diabetes mellitus; needs to conduct major meta-analysis. Int J Pharmacol. 2012;8(6):470–472. doi: 10.3923/ijp.2012.470.472. - DOI
    1. Farshchi A, Nikfar S, Seyedifar M, Abdollahi M. Effect of Chromium on Glucose and Lipid Profiles in Patients with Type 2 Diabetes; A Meta-analysis Review of Randomized Trials. J Pharmacy Pharmaceutical Sci. 2013;16(1):99–114. doi: 10.18433/J3G022. - DOI - PubMed
    1. American Diabetes Association Executive summary: Standards of medical care in diabetes-2013. Diabetes Care. 2013;36(Suppl 1):S4–S10. - PMC - PubMed

Publication types

MeSH terms