系统评价和经济评价的长效胰岛素类似物,胰岛素。

文章的细节

引用
复制到剪贴板

Warren E, Weatherley-Jones E,齐克特J,贝弗利C

系统评价和经济评价的长效胰岛素类似物,胰岛素。

健康评估生物抛光工艺。2004年11月,8(45):第三,1 57。

PubMed ID
15525480 (在PubMed
]
文摘

目的:评估胰岛素的使用在其许可basal-bolus临床和成本效益方面的指示。数据来源:电子数据库。检查方法:系统回顾文献,涉及一系列的数据库,进行识别胰岛素有关的所有文件。结果:19研究满足入选标准但完整的报告只有六个。对于1型糖尿病患者,胰岛素似乎是更有效的比中性鱼精蛋白Hagedorn(一)在降低空腹血糖(FBG),但不降低糖化血红蛋白(HbA1c),有证据表明,胰岛素一样有效的光纤光栅和糖化血红蛋白控制。2型患者口服抗糖尿病的药物为谁提供血糖控制不足,没有证据表明胰岛素比正烷烃更有效减少光纤光栅或糖化血红蛋白和一些证据表明胰岛素一样有效的光纤光栅和糖化血红蛋白控制。依据控制低血糖是模棱两可的。在胰岛素的研究证明是优于正烷烃在控制夜间低血糖,这可能是唯一明显相比,每日一次一组,而不是每天一组。此外,这种优势的甘精在一组控制夜间低血糖可能与一个配方的胰岛素(HOE901[80]),而不是另一个(HOE901 [30])。没有确凿的证据表明胰岛素优于正烷烃在控制低血糖症状和严重的低血糖。 Insufficient data are available to conclude whether insulin glargine is different from each of the commonly used NPH dosing regimens: once daily and more than once daily. Given the lack of a published evidence base for the cost-effectiveness of insulin glargine, the economic review concentrates on a review of the industry submission and an amended model. Three economic models are provided in the submission, two relating to type 1 diabetes and one relating to type 2 diabetes. All three models compare the cost--utility of insulin glargine against NPH insulin. In general, the structures of the models are poor and in all three models, mistakes relating to assumptions and calculations have been made. The assessment team believe that the cost per QALY estimates generated by the Aventis model may be an underestimate for several reasons. The cost-effectiveness of insulin glargine in both type 1 and type 2 diabetes is highly sensitive to the amount of utility associated with reducing the fear of hypoglycaemia. CONCLUSIONS: The evidence suggests that, compared with NPH insulin, insulin glargine is effective in reducing the number of nocturnal hypoglycaemic episodes, especially when compared with once-daily NPH. There appears to be no improvement in long-term glycaemic control and therefore insulin glargine is unlikely to reduce the incidence of the long-term microvascular and cardiovascular complications of diabetes. Further research into insulin glargine is needed that addresses the quality of life issues associated with fear of hypoglycaemia and also the economic impact of balance of HbA1c control and incidence of hypoglycaemia achieved in practice. Studies examining the economic evidence on insulin glargine should be published.

DrugBank数据引用了这篇文章

药物