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The American Journal of Managed Care November 2008
Variation in the Cost of Medications for the Treatment of Colorectal Cancer
Salvatore A. Ferro, PharmD (Cand); Brian S. Myer, BS; Debra A. Wolff, MS; Marek S. Poniewierski, MD, MS; Eva Culakova, PhD; Leon E. Cosler, PhD, RPh; Sarah L. Scarpace, PharmD; Alok A. Khorana, MD; and Gary H. Lyman, MD, MPH, FRCP(Edin)
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Teisha A. Robertson, PharmD, MBA; Catherine E. Cooke, PharmD, BCPS; Jingshu Wang, PhD; Fadia T. Shaya, PhD, MPH; and Helen Y. Lee, PharmD, MBA
Return on Investment for Bariatric Surgery
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Cost and Utilization Avoidance With Mail Prompts: A Randomized Controlled Trial
Gregory D. Berg, PhD; Steven Silverstein, MD; Eileen Thomas, RN; and Allan M. Korn, MD
Supporting the Patient's Role in Guideline Compliance: A Controlled Study
Stephen N. Rosenberg, MD, MPH; Tatiana L. Shnaiden, MD, MS; Arnold A. Wegh, MS; and Iver A. Juster, MD
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Cost-Effectiveness of Insulin Analogs
Diana I. Brixner, PhD, RPh; and Carrie McAdam-Marx, RPh, MS

Cost-Effectiveness of Insulin Analogs

Diana I. Brixner, PhD, RPh; and Carrie McAdam-Marx, RPh, MS
This review shows that insulin analogs are cost-effective versus human insulins based on pharmacoeconomic models and retrospective database analyses.
In the second study,70 costs were estimated based on drug dosages at the end of a 16-week clinical trial of patients receiving biphasic insulin aspart 70/30 plus metformin versus patients receiving 1 or more OADs titrated by their clinicians to optimize glycemic control.71 Direct pharmacy costs were higher for the biphasic insulin aspart 70/30 group. With the biphasic insulin aspart 70/30 regimen, significantly more patients achieved an A1C level of 7.0% or less (P <.02). These patients were considered successfully treated; the mean annual cost for each successfully treated patient was $896 lower with biphasic insulin aspart 70/30.70

CONCLUSIONS
Insulin analogs offer an improved balance between glycemic control and the risk of hypoglycemia, with the resultant potential to reduce the costs of treatment of hypoglycemia, hospitalization, and chronic complications. This better tolerability of analogs and the ease of administration offered by insulin pen devices can help to overcome some of the barriers to insulin use in patients with type 2 DM. Prompt initiation or intensification of insulin therapy in type 2 DM and adherence to an insulin regimen will save costs by delaying or preventing DM complications. Pharmacoeconomic models and retrospective analyses of healthcare databases have consistently shown that treatment with insulin analogs is cost-effective versus other options in the long run. Therefore, the use of insulin analogs in type 1 and type 2 DM is an appropriate investment of healthcare dollars. This review shows that validation of these potential benefits through real-world data analysis is warranted.

Author Affiliations: From the Outcomes Research Center (DIB, CM-M), University of Utah, Salt Lake City.

Funding Source: Novo Nordisk Inc provided an unrestricted educational grant for the preparation of this article. Editorial assistance was provided by Watermeadow Medical.

Author Disclosure: Dr Brixner reports no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article. Dr McAdam-Marx reports serving on the Managed Care Advisory Board for Novo Nordisk Inc.

Authorship Information: Concept and design (DIB, CM-M); analysis and interpretation of data (DIB, CM-M); drafting of the manuscript (CM-M); and critical revision of the manuscript for important intellectual content (DIB, CM-M).

Address correspondence to: Diana I. Brixner, PhD, RPh, Outcomes Research Center, University of Utah, 421 Wakara Way, Ste 208, Salt Lake City, UT 84108. E-mail: diana.brixner@pharm.utha.edu.

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