Limits...
Estimating the real world daily usage and cost for exenatide twice daily and liraglutide in Germany, the Netherlands, and the UK based on volumes dispensed by pharmacies.

McDonell AL, Kiiskinen U, Zammit DC, Kotchie RW, Thuresson PO, Nicolay C, Haslam T, Bruinsma M, Janszen-Van Oosterhout AJ, Otto T - Clinicoecon Outcomes Res (2015)

Bottom Line: Cost is one aspect of treatment to be considered, in addition to clinical benefits, when selecting optimal therapy for a patient.Estimates of average daily dispensed doses of GLP-1 receptor agonists derived from pharmacy data in real world settings corresponded to the dosing recommendation of the summaries of product characteristics.Nevertheless, the mean daily cost of exenatide twice daily was lower than that of liraglutide in Germany, the Netherlands, and the UK.

View Article: PubMed Central - PubMed

Affiliation: IMS Health, London, UK.

ABSTRACT

Background: Glucagon-like peptide-1 (GLP-1) receptor agonists are indicated for improvement of glycemic control in adults with type 2 diabetes. Cost is one aspect of treatment to be considered, in addition to clinical benefits, when selecting optimal therapy for a patient. The objective of this study was to estimate the average dose usage and real world daily cost of the GLP-1 receptor agonists, exenatide twice daily and liraglutide once daily, in Germany, the Netherlands, and the UK.

Methods: Administrative databases were used to source the data from longitudinal records of dispensed prescriptions. Data were extracted from the IMS Longitudinal Prescription database which captures details of prescriptions dispensed in pharmacies. Information on the dispensed quantity of each product was used to estimate average daily usage per patient. Daily dose usage was multiplied by the public price per unit to estimate daily cost.

Results: The dispensed volume in Germany corresponded to a mean dispensed daily dose of 16.81 μg for exenatide twice daily and 1.37 mg for liraglutide (mean daily cost €4.02 and €4.54, respectively). In the Netherlands, average dispensed daily doses of 17.07 μg and 1.49 mg were observed for exenatide twice daily and liraglutide (mean daily cost €3.05 and €3.97, respectively). In the UK, the mean dispensed volume corresponded to a daily usage of 20.49 μg for exenatide twice daily and 1.50 mg for liraglutide (mean daily cost £2.53 and £3.28, respectively).

Conclusion: Estimates of average daily dispensed doses of GLP-1 receptor agonists derived from pharmacy data in real world settings corresponded to the dosing recommendation of the summaries of product characteristics. Nevertheless, the mean daily cost of exenatide twice daily was lower than that of liraglutide in Germany, the Netherlands, and the UK. Such estimates can be used to inform health care decision-makers on the real world usage and cost of medications effective in achieving glycemic control in patients with type 2 diabetes.

No MeSH data available.


Related in: MedlinePlus

Dosing titration of exenatide twice daily (A) according to the Summary of Product Characteristics. The dosage for exenatide twice daily can be doubled after 4 weeks if better GC is needed.7 The starting dose for liraglutide (B) is 0.6 mg and can be increased after 1 week to 1.2 mg; if better GC is needed, it can be increased to reach 1.8 mg.8Abbreviation: GC, glycemic control.
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f1-ceor-7-095: Dosing titration of exenatide twice daily (A) according to the Summary of Product Characteristics. The dosage for exenatide twice daily can be doubled after 4 weeks if better GC is needed.7 The starting dose for liraglutide (B) is 0.6 mg and can be increased after 1 week to 1.2 mg; if better GC is needed, it can be increased to reach 1.8 mg.8Abbreviation: GC, glycemic control.

Mentions: The first step in diabetes management is lifestyle intervention.4 If this step is not sufficient to maintain glucose control, the next step is to initiate treatment with an oral glucose-lowering drug, most often metformin, proceeding to addition of second-line and third-line therapeutic agents if necessary. Exenatide twice daily (Byetta®, AstraZeneca, London, UK) and liraglutide (Victoza®, Novo Nordisk, Bagsvaerd, Denmark) are the third-line choices of therapy most often considered by European health care systems based on treatment guidelines.5 They both belong to the class of glucagon-like peptide-1 (GLP-1) receptor agonists and have similar mechanisms of action. Several clinical trials have investigated the efficacy of exenatide twice daily and liraglutide in patients with type 2 diabetes. A more recent study compared liraglutide 1.8 mg once daily with exenatide 10 μg twice daily,6 and showed that there are differences between agents in the GLP-1 receptor agonist class. Overall, liraglutide 1.8 mg once daily was found to have better efficacy in terms of improving glycemic control and better tolerability when compared with exenatide 10 μg twice daily.6 Both therapies are initiated at a starting dose (Figure 1) according to their respective Summary of Product Characteristics.7,8 The exenatide twice daily dose can be increased once, whereas liraglutide may be titrated upward twice if needed to achieve better glycemic control.


Estimating the real world daily usage and cost for exenatide twice daily and liraglutide in Germany, the Netherlands, and the UK based on volumes dispensed by pharmacies.

McDonell AL, Kiiskinen U, Zammit DC, Kotchie RW, Thuresson PO, Nicolay C, Haslam T, Bruinsma M, Janszen-Van Oosterhout AJ, Otto T - Clinicoecon Outcomes Res (2015)

Dosing titration of exenatide twice daily (A) according to the Summary of Product Characteristics. The dosage for exenatide twice daily can be doubled after 4 weeks if better GC is needed.7 The starting dose for liraglutide (B) is 0.6 mg and can be increased after 1 week to 1.2 mg; if better GC is needed, it can be increased to reach 1.8 mg.8Abbreviation: GC, glycemic control.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4321412&req=5

f1-ceor-7-095: Dosing titration of exenatide twice daily (A) according to the Summary of Product Characteristics. The dosage for exenatide twice daily can be doubled after 4 weeks if better GC is needed.7 The starting dose for liraglutide (B) is 0.6 mg and can be increased after 1 week to 1.2 mg; if better GC is needed, it can be increased to reach 1.8 mg.8Abbreviation: GC, glycemic control.
Mentions: The first step in diabetes management is lifestyle intervention.4 If this step is not sufficient to maintain glucose control, the next step is to initiate treatment with an oral glucose-lowering drug, most often metformin, proceeding to addition of second-line and third-line therapeutic agents if necessary. Exenatide twice daily (Byetta®, AstraZeneca, London, UK) and liraglutide (Victoza®, Novo Nordisk, Bagsvaerd, Denmark) are the third-line choices of therapy most often considered by European health care systems based on treatment guidelines.5 They both belong to the class of glucagon-like peptide-1 (GLP-1) receptor agonists and have similar mechanisms of action. Several clinical trials have investigated the efficacy of exenatide twice daily and liraglutide in patients with type 2 diabetes. A more recent study compared liraglutide 1.8 mg once daily with exenatide 10 μg twice daily,6 and showed that there are differences between agents in the GLP-1 receptor agonist class. Overall, liraglutide 1.8 mg once daily was found to have better efficacy in terms of improving glycemic control and better tolerability when compared with exenatide 10 μg twice daily.6 Both therapies are initiated at a starting dose (Figure 1) according to their respective Summary of Product Characteristics.7,8 The exenatide twice daily dose can be increased once, whereas liraglutide may be titrated upward twice if needed to achieve better glycemic control.

Bottom Line: Cost is one aspect of treatment to be considered, in addition to clinical benefits, when selecting optimal therapy for a patient.Estimates of average daily dispensed doses of GLP-1 receptor agonists derived from pharmacy data in real world settings corresponded to the dosing recommendation of the summaries of product characteristics.Nevertheless, the mean daily cost of exenatide twice daily was lower than that of liraglutide in Germany, the Netherlands, and the UK.

View Article: PubMed Central - PubMed

Affiliation: IMS Health, London, UK.

ABSTRACT

Background: Glucagon-like peptide-1 (GLP-1) receptor agonists are indicated for improvement of glycemic control in adults with type 2 diabetes. Cost is one aspect of treatment to be considered, in addition to clinical benefits, when selecting optimal therapy for a patient. The objective of this study was to estimate the average dose usage and real world daily cost of the GLP-1 receptor agonists, exenatide twice daily and liraglutide once daily, in Germany, the Netherlands, and the UK.

Methods: Administrative databases were used to source the data from longitudinal records of dispensed prescriptions. Data were extracted from the IMS Longitudinal Prescription database which captures details of prescriptions dispensed in pharmacies. Information on the dispensed quantity of each product was used to estimate average daily usage per patient. Daily dose usage was multiplied by the public price per unit to estimate daily cost.

Results: The dispensed volume in Germany corresponded to a mean dispensed daily dose of 16.81 μg for exenatide twice daily and 1.37 mg for liraglutide (mean daily cost €4.02 and €4.54, respectively). In the Netherlands, average dispensed daily doses of 17.07 μg and 1.49 mg were observed for exenatide twice daily and liraglutide (mean daily cost €3.05 and €3.97, respectively). In the UK, the mean dispensed volume corresponded to a daily usage of 20.49 μg for exenatide twice daily and 1.50 mg for liraglutide (mean daily cost £2.53 and £3.28, respectively).

Conclusion: Estimates of average daily dispensed doses of GLP-1 receptor agonists derived from pharmacy data in real world settings corresponded to the dosing recommendation of the summaries of product characteristics. Nevertheless, the mean daily cost of exenatide twice daily was lower than that of liraglutide in Germany, the Netherlands, and the UK. Such estimates can be used to inform health care decision-makers on the real world usage and cost of medications effective in achieving glycemic control in patients with type 2 diabetes.

No MeSH data available.


Related in: MedlinePlus