Abstract:
Objectives: The increasing number of long-acting insulin analogues makes it difficult for general practitioners to have sufficient knowledge of each individual insulin formulation and device. Reducing the number of different insulin analogues used, based on rational criteria, allows physicians and pharmacists to build experience with a more limited set of medicines and to optimize patient information. The costs of newer formulations also need to be considered.
Methods: In this study long-acting insulin analogues are compared by means of the System of Objectified Judgement Analysis (SOJA) method. The following selection criteria were applied: effectiveness, safety, tolerability, ease of use, and applicability. Concrete sub-criteria for each selection criteria were defined.
Results and conclusion: We found almost identical scores for the long-acting insulin analogues. Therefore, acquisition cost and individual patient characteristics should be used to determine the choice of formulary products. Glargine 100 IU/mL (biosimilar or originator) is the cheapest option in most cases. It should be noted that ‘good old’ Neutral Protamine Hagedorn (NPH) insulin is still a good treatment option from a formulary perspective NPH insulin is also likely to be cheaper than biosimilar glargine in most countries.

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