Objective:

Pharmacological strategies for the management of patients with type 2 diabetes include lispro protamine insulin (NPL) and NPH insulin + rapid insulin. The cost-effectiveness study addresses the economic and epidemiological aspects in the process of choosing between two or more alternatives. The objective is to determine the cost effectiveness of lispro protamine insulin (NPL) vs. combination of NPH insulin + rapid insulin.

Methods:

Cost effectiveness study in patients with type 2 diabetes. Alternative 1: lispro protamine insulin (NPL) and alternative 2: NPH insulin + rapid insulin. Sample size 62 per group, simple random sampling technique. Cost (estimated in Mexican pesos) included, unit cost, intensity of use of the service, average cost per input, average cost per service, and cost per type of alternative (including family medicine, laboratory and medication.) Effectiveness was determined with the average glucose results carried out throughout the year. Analysis plan included cost effectiveness analysis and incremental cost effectiveness analysis.

Results:

The total average cost of lispro protamine insulin (NPL) and NPH insulin + rapid insulin mixture was $6,146.30 and $2,671.02, respectively. The NPH insulin + rapid insulin mixture alternative has lower cost and greater effectiveness. According to the cost effectiveness analysis, with the NPH insulin + rapid insulin mixture alternative, there was a saving of $159.98 for each milligram of glucose per deciliter comparing to the lispro protamine insulin (NPL) alternative.

Conclusion:

According with our results, a better cost-effectiveness ratio was obtained in NPH insulin + rapid insulin.

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