Abstract

HINCAPIE GARCIA, JAIME ALEJANDRO et al. Sitagliptin vs insulin in hospitalized patients with type 2 diabetes: a comparative cost analysis. CES Med. [online]. 2015, vol.29, n.1, pp.89-99. ISSN 0120-8705.

Patients with type 2 diabetes admitted to the hospital have traditionally been treated with basal/bolus insulin. A study published by Umpierrez et al., has shown that the same glucose control can be achieved with Sitagliptin (DPP IV inhibitor) compared to insulin glargine and glulisine. Based on this data a cost analysis was made to assess if this strategy would change inpatient diabetic care in Colombia. Objectives: To determine, from a published randomized clinical trial, the cost of utilizing Sitagliptin or Sitagliptin and basal insulin or basal / bolus insulin in patients hospitalized with a diagnosis of T2DM. Methods: The study evaluated three arms: 1) Sitagliptin + supplemental insulin, 2) Sitagliptin + basal insulin + supplemental insulin and 3) Insulin basal / bolus + supplemental insulin. A Cost matrix was designed with type cases for each arm. It took into account the possibility of therapeutic failure and the need for corrections with a fast-acting insulin. A sensitivity analysis was performed in a platform, evaluating the influence of changes in the cost of Sitagliptin. Results: In the base case, a difference of $2 COP (Colombian pesos) was observed between the use of Sitagliptin + supplemental insulin compared with the basal/bolus + supplemental insulin strategy. The model is sensitive to the change in price of Sitagliptin. The Sitagliptin + Basal insulin strategy was the most expensive. Conclusion: In the 3 scenarios analyzed there was no difference between using Sitagliptin + supplemental insulin or basal / bolus + supplemental insulin in diabetic patients admitted to the hospital who were being treated with diet and exercise, oral agents or insulin at doses less than 0.4 IU / kg. The model is sensitive to changes in the cost of Sitagliptin.

Keywords : Diabetes mellitus; Sitagliptin; Cost; Hospitalisation; Insulin.

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