Pharmacoeconomic Evaluation and Effect of Insulin Glargine and Insulin Detemir in Patients with Type 1 Diabetes Mellitus: A Comparative Analysis

Background: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder with
rising global prevalence, imposing significant health and economic burdens. Key
treatments for T1DM include long-acting insulin analogs like insulin glargine and
insulin detemir. However, comparative pharmacoeconomic analyses of these
medications remain limited.
Objectives: This research evaluated the cost-effectiveness, glycemic control, and
safety profiles of insulin glargine and insulin detemir in individuals with type 1
diabetes mellitus (T1DM).
Methods: A prospective observational study involving 353 adult patients with T1DM
was carried out over 1.5 years at a tertiary care hospital in South India. Data were
collected on demographics, glycemic control (HbA1c levels), incidence of
hypoglycemia, and treatment costs.Statistical analyses, including descriptive
statistics and the incremental cost-effectiveness ratio (ICER), were conducted using
SPSS version 24.
Results: Participants had a mean age of 46.1 ± 10.8 years, with 69.97% being male.
HbA1c reduction was comparable between treatments (Glargine: -1.64%, Detemir: -
1.57%). Severe hypoglycemia rates were similar, with 0.69 and 0.61 episodes per
100 person-years for Glargine and Detemir, respectively. Glargine and Detemir had
about the same number of total hypoglycemia cases, with 90.94 episodes for every
100 people each year. However, Insulin glargine demonstrated a notable cost
advantage, with an annual treatment cost of INR 18,197.58 compared to INR
26,314.07 for Detemir. ICER of INR 8,116.49 per annum.The reduced cost of
Glargine was attributed to lower daily dose requirements and a lower per-unit cost.
Conclusion: Both Insulin glargine and Insulin detemir are effective and safe for
managing T1DM. However, Insulin glargine is more cost-effective, making it a
preferable option, especially in resource-limited healthcare settings. These findings
highlight the importance of integrating clinical outcomes and cost considerations in
diabetes management strategies. To assess long-term effects and wider population
applications, further study is required.