Insulin glargine may be cost-effective compared with basal insulin.

Picture of a syringe

Insuline glargine has several clinical and quality of life benefits compared with human basal insulin (NPH).  However, it is also more costly.  Do these benefits justify the additional cost?

A new economic evaluation addresses this question.  The authors searched the literature for published evaluations.  They found seven good quality studies that addressed the issue, though from different perspectives and using different approaches.

There was also a great deal of variation in the findings of the studies.  Four of them rated glargine as “cost-effective” in their overall assessment, assuming a “willingness to pay” threshold of € 30,000 per additional QALY (Quality-Adjusted Life Year) gained.

Appraisal guide

Users of this research should consider:

  • Whether the estimates of costs and benefits are realistic in their own setting
  • What other aspects of study design could account for the wide discrepancy in findings between different studies
  • Whether all important costs, benefits and adverse outcomes have been incorporated into the analysis
  • The details of the individual studies included in the review, and whether an individual study that is similar to their own circumstances would provide better evidence.


Full text is available from the following link:

Hagenmeyer EG, Koltermann KC, Dippel FW, Schadlich PK. Health economic evaluations comparing insulin glargine with NPH insulin in patients with type 1 diabetes: a systematic review. Cost Eff Resour Alloc. 2011 Oct 6;9(1):15. [Epub ahead of print]

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I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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