Abstracts by key term: Basal insulin
With around six million diagnosed patients, diabetes mellitus is one of the most common chronic diseases in Germany. In addition, the number of diabetics is increasing - regardless of population aging (RKI 2011). In addition, diabetes is one of the most costly diseases. In statutory health insurance (GKV), a diabetic incurs about twice as high direct treatment costs as a non-diabetic insured person (Köster et al. 2006). Almost 30 percent of all diabetics are treated with insulin (Hauner 2007); These include all type 1 diabetics and those type 2 diabetics for whom the body's own insulin production is no longer sufficient despite lifestyle changes and treatment with oral antidiabetics. When it comes to insulin, a distinction can be made between mixed insulins, short-acting, so-called bolus insulins, and long-acting, so-called basal insulins. The latter include NPH insulin (Neutral Protamine Hagedorn), insulin glargine and insulin detemir. Basal insulin accounts for around 30 percent of the total daily insulin doses prescribed on an outpatient basis and 34 percent of statutory health insurance expenditure on insulin (Mengel 2010; INSIGHT Health 2011). The aim of the study presented here is to compare the costs of three treatment strategies that differ in terms of the basal insulin used. Only diabetics who received at least two prescriptions of either insulin glargine or insulin detemir or NPH insulin at the expense of the statutory health insurance in 2010 are included. The outpatient diabetes-related prescriptions for bolus insulins, antidiabetics, blood sugar test strips, needles and lancets billed via pharmacy computing centers are also taken into account. The prescriptions are valued at pharmacy sales prices (Lauer tax) less the statutory manufacturer discounts in accordance with Section 130a Paragraphs 1, 1a, 3b SGB V.
02.10.2012
The aim of the present analysis is to compare treatment costs between insulin-glargine and NPH-insulin-based therapies in patients with diabetes mellitus. Using a representative sample of health insurance data, simultaneous co-medication in the indication groups bolus insulin, oral antidiabetics, test strips and lancets/needles over three calendar years was determined for a total of six payers. During the analysis period (2006 - 2008), the aggregated absolute annual treatment costs per diabetes patient for insulin glargine-based therapies tended to be slightly below the costs of the respective NPH comparison groups. The analysis of the individual costs shows that the higher procurement costs for insulin glargine are overcompensated by savings in bolus insulin and test strip consumption. The present database analysis confirms the results of previously published health care research studies, according to which, from the perspective of statutory health insurance (GKV), there is a cost-neutrality between insulin glargine and NPH insulin-based treatment regimens under real care conditions.