LI Jie,LI Hong,CHEN Guanji,et al.Rapid health technology assessment of insulin icodec for the treatment of type 2 diabetes mellitus[J].ZHONGGUO YAOFANG,2025,36(22):2856-2861.
LI Jie,LI Hong,CHEN Guanji,et al.Rapid health technology assessment of insulin icodec for the treatment of type 2 diabetes mellitus[J].ZHONGGUO YAOFANG,2025,36(22):2856-2861. DOI: 10.6039/j.issn.1001-0408.2025.22.18.
Rapid health technology assessment of insulin icodec for the treatment of type 2 diabetes mellitus
To comprehensively evaluate the efficacy, safety and cost-effectiveness of insulin icodec in treating type 2 diabetes mellitus (T2DM), providing evidence-based guidance for new drug selection in hospital and clinical medication decision-making.
METHODS
2
PubMed, Cochrane Library, Embase, CNKI, Wanfang, VIP and foreign health technology assessment (HTA) websites were searched by using rapid health technology assessment from inception to 15 July 2025 for systematic reviews/meta-analyses, pharmacoeconomic studies, and HTA reports on insulin icodec in the treatment of T2DM. After data extraction and quality assessment, the findings of the included studies were analyzed descriptively.
RESULTS
2
Ten systematic reviews/meta-analyses and three pharmacoeconomic studies were included. Among them, 4 systematic reviews/meta-analyses were of high quality; the overall quality of the 3 pharmacoeconomic studies was relatively good. Regarding efficacy, insulin icodec was superior to once-daily basal insulin in reducing glycated hemoglobin (HbA1c) and in achieving the target of HbA1c<7% (
P
<0.05). No significant differences were observed between icodec insulin and comparators in lowering fasting plasma glucose (
P
>0.05). For safety, insulin icodec did not increase the incidence of any adverse events (AEs), serious AEs, clinically significant hypoglycemia (random glucose<3 mmol/L), in
jection-site reactions, or allergic reactions, compared with once-daily basal insulin overall (
P
>0.05); however, insulin icodec was associated with a significant increase in body weight (
P
<0.05). Domestic economic evaluations indicated that insulin icodec was more cost-effective than insulin glargine and insulin degludec when its annual costs were in the range of 784.90-1 145.96 and 597.66-736.34 US dollars, respectively.
CONCLUSIONS
2
Insulin icodec demonstrates favorable efficacy and safety profiles in the treatment of T2DM; however, attention should be paid to the risk of weight gain. Under China’s healthcare system, insulin icodec demonstrates greater economic value only when the patient’s weekly required basal insulin dose falls within a specific range,and clinical practice requires individualization.
关键词
Keywords
references
ZHOU Y C , LIU J M , ZHAO Z P , et al . The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050 [J ] . Mil Med Res , 2025 , 12 ( 1 ): 28 .
WILLIAMS R , KARURANGA S , MALANDA B , et al . Global and regional estimates and projections of diabetes-related health expenditure:results from the International Diabetes Federation Diabetes Atlas,9th edition [J ] . Diabetes Res Clin Pract , 2020 , 162 : 108072 .
ZHONG V W , YU D M , ZHAO L Y , et al . Achievement of guideline-recommended targets in diabetes care in China:a nationwide cross-sectional study [J ] . Ann Intern Med , 2023 , 176 ( 8 ): 1037 - 1046 .
KJELDSEN T B , HUBÁLEK F , HJØRRINGGAARD C U , et al . Molecular engineering of insulin icodec,the first acylated insulin analog for once-weekly administration in humans [J ] . J Med Chem , 2021 , 64 ( 13 ): 8942 - 8950 .
NISHIMURA E , PRIDAL L , GLENDORF T , et al . Molecular and pharmacological characterization of insulin icodec:a new basal insulin analog designed for once-weekly dosing [J ] . BMJ Open Diabetes Res Care , 2021 , 9 ( 1 ): e002301 .
HUSEREAU D , DRUMMOND M , AUGUSTOVSKI F , et al . Consolidated health economic evaluation reporting standards 2022(CHEERS 2022) statement:updated reporting guidance for health economic evaluations [J ] . Value Health , 2022 , 25 ( 1 ): 3 - 9 .
DUTTA D , NAGENDRA L , BHAT S , et al . Optimal use of once weekly icodec insulin in type-2 diabetes:an updated meta-analysis of phase-2 and phase-3 randomized controlled trials [J ] . Diabetes Metab Syndr , 2023 , 17 ( 10 ): 102877 .
RIBEIRO E SILVA R , DE MIRANDA GAUZA M , GUISSO M E S , et al . Once-weekly insulin icodec vs. once-daily insulin glargine U100 for type 2 diabetes:a systematic review and meta-analysis of phase 2 randomized controlled trials [J ] . Arch Endocrinol Metab , 2023 , 67 ( 5 ): e000614 .
ABUELAZM M , IBRAHIM A A , KHLIDJ Y , et al . Once-weekly insulin icodec versus once-daily long-acting insulin for type Ⅱ diabetes:a meta-analysis of randomized controlled trials [J ] . J Endocr Soc , 2023 , 8 ( 2 ): bvad177 .
AHMED M , SHAFIQ A , JAVAID H , et al . Clinical outcomes with once-weekly insulin icodec versus once-daily insulin glargine U100 in insulin-naïve and previously insulin-treated individuals with type 2 diabetes:a meta-analysis of randomised controlled trials [J ] . Endocrinol Diabetes Metab , 2024 , 7 ( 3 ): e00480 .
BAJAJ H S , ÁSBJÖRNSDÓTTIR B , BARI T J , et al . Once-weekly insulin icodec compared with daily basal insulin analogues in type 2 diabetes:participant-level meta-analysis of the ONWARDS 1-5 trials [J ] . Diabetes Obes Metab , 2024 , 26 ( 9 ): 3810 - 3820 .
MUKHOPADHYAY P , CHATTERJEE P , PANDIT K , et al . Once-weekly insulin icodec as compared to once-daily basal insulins:a meta-analysis [J ] . Endocr Pract , 2024 , 30 ( 2 ): 128 - 134 .
SALEEM S Z , FAREED A , AKHTAR S M M , et al . Efficacy and safety of once-weekly insulin icodec compared to once-daily insulin g U-100 in patients with type Ⅱ diabetes:a systematic review and meta-analysis [J ] . Diabetol Metab Syndr , 2024 , 16 ( 1 ): 80 .
SHETTY S , SUVARNA R . Efficacy and safety of once-weekly insulin icodec in type 2 diabetes:a meta-analysis of ONWARDS phase 3 randomized controlled trials [J ] . Diabetes Obes Metab , 2024 , 26 ( 3 ): 1069 - 1081 .
ZUHAIR V , OBAID M A , MUSTAFA M S , et al . Evalua-ting the efficacy and safety of weekly insulin icodec vs. daily insulin glargine in type 2 diabetes mellitus:a syste-matic review and meta-analysis [J ] . J Diabetes Metab Disord , 2024 , 23 ( 1 ): 1337 - 1349 .
DAI N , SU X R , WANG Y . Cost-utility analysis of once-weekly insulin icodec and once-daily insulin glargine in patients with type 2 diabetes receiving basal-bolus insulin therapy in China [J ] . Diabetes Obes Metab , 2025 , 27 ( 1 ): 377 - 386 .
HU S S , WANG S W , GU S Y , et al . Cost-utility analysis and drug pricing of once-weekly insulin icodec versus once-daily insulin degludec for type 2 diabetes patients treated with basal insulin in China [J ] . Diabetes Obes Metab , 2024 , 26 ( 12 ): 5995 - 6006 .
TORRE E , DI MATTEO S , BRUNO G M , et al . Economic evaluation of once-weekly insulin icodec from Italian NHS perspective [J ] . Clinicoecon Outcomes Res , 2024 , 16 : 799 - 811 .
BAJAJ H S , ABERLE J , DAVIES M , et al . Once-weekly insulin icodec with dosing guide app versus once-daily basal insulin analogues in insulin-naive type 2 diabetes(ONWARDS 5):a randomized trial [J ] . Ann Intern Med , 2023 , 176 ( 11 ): 1476 - 1485 .