The clinical effectiveness of insulin glargine in patients with type 1 diabetes in Brazil : findings and implications

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Marra, Lays P. and Araújo, Vânia E. and Oliveria, Gerusa C. C. and Diniz, Leonardo M. and Guerra Júnior, Augusto A. and de Assis Acurcio, Francisco and Godman, Brian and Álvares, Juliana (2017) The clinical effectiveness of insulin glargine in patients with type 1 diabetes in Brazil : findings and implications. Journal of Comparative Effectiveness Research. ISSN 2042-6313 (https://doi.org/10.2217/cer-2016-0099)

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Abstract

Aims: Published studies have challenged the cost-effectiveness of insulin glargine versus NPH insulins in Brazil with limited evidence of increased effectiveness despite considerably higher acquisition costs. However, still a controversy. Consequently, a need to address this. Methods: Retrospective cohort study of type 1 diabetes patients receiving insulin glargine in Brazil following NPH insulin who met the criteria. Results: 580 patients were enrolled. HbA1c varied from 8.80 ± 1.98% in NPH insulin users to 8.54 ± 1.88% after insulin glargine for six months, which is not clinically significant. Frequency of glycemic control varied from 22.6% with NPH insulin to 26.2% with insulin glargine. No statistically significant difference was observed between controlled and still uncontrolled groups for all analyzed factors including type and frequency of insulin use and carbohydrate counting. Conclusions: Limited differences between NPH insulins and insulin analogues in routine clinical care does not justify an appreciable cost difference.

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