Objective: To assess the cost-effectiveness of insulin icodec (IIco), the first once-weekly basal insulin, for the treatment of T2D from the Canadian public payer perspective using the Institute for Health Economics - Diabetes Cohort Model.
Three T2D patient groups were analyzed: insulin naïve (IN), basal insulin experienced (BExp), and basal-bolus insulin experienced (BBExp). Comparators included basal insulin analogs currently reimbursed in Canada: insulin glargine (IGlar) U100 & U300, insulin degludec (IDeg) U100 & U200, and insulin detemir (IDet). Comparative data were derived from IIco phase 3 ONWARDS trials and network meta-analyses. Three price points for IIco were considered: equal to originator IGlar U100, equal to IDeg, and 10% higher than IDeg. Outcomes were expressed as quality-adjusted life-years (QALYs), and cost-effectiveness as incremental cost utility ratios (ICUR [cost/QALY]).
Results: For the IN and BExp populations, IIco is either dominant or associated with an ICUR ≤ $28,824 in all analyses. For the BBExp population, IIco is either dominant or associated with an ICUR ≤ $45,433 in all analyses, except for the comparison versus IGlar U100 when IIco price is ≥ IDeg, and versus IGlar U300 when IIco price is = IDeg +10%.
At a willingness-to-pay threshold of $50,000/QALY gained, IIco is a cost-effective treatment option for T2D versus once daily basal insulin analogues currently reimbursed in Canada.
D.A. Garcia: Other Relationship; Novo Nordisk Canada Inc. G. Mau: Employee; Novo Nordisk Canada Inc. V. Vuong: Other Relationship; Novo Nordisk Canada Inc. S. Singh: Other Relationship; EVERSANA. M.S. Jensen: Employee; Novo Nordisk A/S. R. Goldenberg: Speaker's Bureau; Bayer Inc., Boehringer-Ingelheim. Advisory Panel; Eli Lilly and Company, HLS Therapeutics Inc., Novo Nordisk, Sanofi.
