Limits...
Cost-Effectiveness Analysis of Incretin Therapy for Type 2 Diabetes in Spain: 1.8 mg Liraglutide Versus Sitagliptin.

Pérez A, Mezquita Raya P, Ramírez de Arellano A, Briones T, Hunt B, Valentine WJ - Diabetes Ther (2015)

Bottom Line: Liraglutide was associated with increased direct costs (EUR 56,628 versus EUR 52,450), driven by increased pharmacy costs.Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio of EUR 10,436 per QALY gained versus sitagliptin.A previous analysis has suggested that 1.2 mg liraglutide is cost-effective from a healthcare payer perspective in Spain, and the present analysis suggests that the 1.8 mg dose is also likely to be cost-effective.

View Article: PubMed Central - PubMed

Affiliation: Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

ABSTRACT

Objectives: Metformin is the first-line therapy for most patients with type 2 diabetes, but the majority require treatment intensification at some stage due to the progressive nature of the disease. The 1860-LIRA-DPP-4 trial showed that liraglutide exhibited greater improvements compared with sitagliptin in glycated hemoglobin and body mass index in patients with type 2 diabetes inadequately controlled on metformin monotherapy. As a follow-up to a previously published cost-effectiveness analysis of 1.2 mg liraglutide versus sitagliptin in Spain, the aim of this analysis was to compare long-term projections of the clinical and cost implications associated with 1.8 mg liraglutide and sitagliptin.

Methods: For the modeling analysis, 52-week treatment effect data (as opposed to 26-week data in the previous analysis) were taken from the 1860-LIRA-DPP-4 trial, for adults with type 2 diabetes receiving 1.8 mg liraglutide or 100 mg sitagliptin daily in addition to metformin. Long-term (patient lifetime) projections of clinical outcomes and direct costs (2012 EUR) were made using a published and validated model of type 2 diabetes, with modeling assumptions as per the 1.2 mg liraglutide analysis.

Results: Liraglutide was associated with increased life expectancy (14.24 versus 13.87 years) and quality-adjusted life expectancy [9.24 versus 8.84 quality-adjusted life years (QALYs)] over sitagliptin. Improved clinical outcomes were attributable to the improvement in glycemic control, leading to a reduced incidence of diabetes-related complications, including renal disease, cardiovascular disease, ophthalmic and diabetic foot complications. Liraglutide was associated with increased direct costs (EUR 56,628 versus EUR 52,450), driven by increased pharmacy costs. Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio of EUR 10,436 per QALY gained versus sitagliptin.

Conclusions: A previous analysis has suggested that 1.2 mg liraglutide is cost-effective from a healthcare payer perspective in Spain, and the present analysis suggests that the 1.8 mg dose is also likely to be cost-effective.

No MeSH data available.


Related in: MedlinePlus

Mean direct costs with liraglutide and sitagliptin over patient lifetimes. EUR 2012 Euros
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4374077&req=5

Fig2: Mean direct costs with liraglutide and sitagliptin over patient lifetimes. EUR 2012 Euros

Mentions: Liraglutide was associated with increased direct costs of EUR 4177 per patient versus sitagliptin (EUR 56,628 versus EUR 52,450) (Table 3; Fig. 2). The increased acquisition cost of liraglutide over sitagliptin (accrued during the first 5 years of the analysis) drove this difference. However, the reduced costs of treating diabetes-related complications partially offset this increased cost. The most notable savings were made as a result of avoided diabetic foot complications, where mean savings of EUR 2173 per patient were made (EUR 17,901 versus EUR 20,074).Fig. 2


Cost-Effectiveness Analysis of Incretin Therapy for Type 2 Diabetes in Spain: 1.8 mg Liraglutide Versus Sitagliptin.

Pérez A, Mezquita Raya P, Ramírez de Arellano A, Briones T, Hunt B, Valentine WJ - Diabetes Ther (2015)

Mean direct costs with liraglutide and sitagliptin over patient lifetimes. EUR 2012 Euros
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4374077&req=5

Fig2: Mean direct costs with liraglutide and sitagliptin over patient lifetimes. EUR 2012 Euros
Mentions: Liraglutide was associated with increased direct costs of EUR 4177 per patient versus sitagliptin (EUR 56,628 versus EUR 52,450) (Table 3; Fig. 2). The increased acquisition cost of liraglutide over sitagliptin (accrued during the first 5 years of the analysis) drove this difference. However, the reduced costs of treating diabetes-related complications partially offset this increased cost. The most notable savings were made as a result of avoided diabetic foot complications, where mean savings of EUR 2173 per patient were made (EUR 17,901 versus EUR 20,074).Fig. 2

Bottom Line: Liraglutide was associated with increased direct costs (EUR 56,628 versus EUR 52,450), driven by increased pharmacy costs.Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio of EUR 10,436 per QALY gained versus sitagliptin.A previous analysis has suggested that 1.2 mg liraglutide is cost-effective from a healthcare payer perspective in Spain, and the present analysis suggests that the 1.8 mg dose is also likely to be cost-effective.

View Article: PubMed Central - PubMed

Affiliation: Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

ABSTRACT

Objectives: Metformin is the first-line therapy for most patients with type 2 diabetes, but the majority require treatment intensification at some stage due to the progressive nature of the disease. The 1860-LIRA-DPP-4 trial showed that liraglutide exhibited greater improvements compared with sitagliptin in glycated hemoglobin and body mass index in patients with type 2 diabetes inadequately controlled on metformin monotherapy. As a follow-up to a previously published cost-effectiveness analysis of 1.2 mg liraglutide versus sitagliptin in Spain, the aim of this analysis was to compare long-term projections of the clinical and cost implications associated with 1.8 mg liraglutide and sitagliptin.

Methods: For the modeling analysis, 52-week treatment effect data (as opposed to 26-week data in the previous analysis) were taken from the 1860-LIRA-DPP-4 trial, for adults with type 2 diabetes receiving 1.8 mg liraglutide or 100 mg sitagliptin daily in addition to metformin. Long-term (patient lifetime) projections of clinical outcomes and direct costs (2012 EUR) were made using a published and validated model of type 2 diabetes, with modeling assumptions as per the 1.2 mg liraglutide analysis.

Results: Liraglutide was associated with increased life expectancy (14.24 versus 13.87 years) and quality-adjusted life expectancy [9.24 versus 8.84 quality-adjusted life years (QALYs)] over sitagliptin. Improved clinical outcomes were attributable to the improvement in glycemic control, leading to a reduced incidence of diabetes-related complications, including renal disease, cardiovascular disease, ophthalmic and diabetic foot complications. Liraglutide was associated with increased direct costs (EUR 56,628 versus EUR 52,450), driven by increased pharmacy costs. Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio of EUR 10,436 per QALY gained versus sitagliptin.

Conclusions: A previous analysis has suggested that 1.2 mg liraglutide is cost-effective from a healthcare payer perspective in Spain, and the present analysis suggests that the 1.8 mg dose is also likely to be cost-effective.

No MeSH data available.


Related in: MedlinePlus