A cost-utility analysis of long-acting insulin analogues (detemir, glargine and degludec) for the treatment of adult type 1 diabetes in South Africa

Table 2 Model inputs: insulin utilisation, inpatient admission, unit costs and health related quality of life

Parameters	Base value	Range for PSA	Source
Insulin utilisation
Mean weight (kg)	81.2	± 17.8	Heller [29]
Total units of insulin per kg per day (U/kg/day)	0.60	0.5–1.0	EML and FDA [10, 30,31,32,33]
Proportion of total that is NPH insulin	0.45	0.40–0.50	EML
Proportion of total that is insulin Detemir	0.33	-	FDA [31]
Proportion of total that is insulin Glargine-U100	0.33	-	FDA [30]
Proportion of total that is insulin Glargine-U300	0.33	0.33–0.50	FDA [32]
Proportion of total that is insulin Degludec	0.33	0.33–0.50	FDA [33]
Inpatient utilisation
Proportion of severe hypoglycaemia requiring inpatient admission	0.33	0.25–0.36	Hammer [36]
Length of stay (days)	2.0	1.0–6.0	Hammer [36]
Insulin cost per patient day (USD)
NPH: Protaphane injection 10 ml (100 U/ml)	0.05		Calculated using MHPL Oct 2020 [34]
Detemir: Levemir cartridge 5 × 3 ml (100 U/ml)	0.31		Calculated using MPR Dec 2020 [35]
Glargine-U100: Lantus injection 10 ml (100 U/ml)	0.48		Calculated using MHPL Oct 2020 [34]
Glargine-U300: Teajou pen 3 × 1.5 ml (300 U/ml)	0.39		Calculated using MPR Dec 2020 [35]
Degludec: Tresiba cartridge 5 × 3 ml (100 U/ml)	0.64		Calculated using MPR Dec 2020 [35]
Cost per inpatient day (US$)	192.61		DHB 2019/20 [37]
Health related quality of life values
T1DM no complications	0.84	0.76–0.92	Evans [36]
T1DM nocturnal hypoglycaemia	0.77	0.70–0.85	Evans [36]

ISSN: 1478-7547