Ronan Roussel1,2,3, Luc Martinez4, Tom Vandebrouck5, Habiba Douik6, Patrick Emiel6, Matthieu Guery6, Barnaby Hunt7, William J Valentine7. 1. a a AP-HP, Bichat Hospital, Department of Diabetology-Endocrinology-Nutrition, Department Hospital University FIRE , Paris , France. 2. b b INSERM, UMRS 1138, Centre de Recherche des Cordeliers , Paris , France. 3. c c University Paris Diderot Sorbonne Paris Cité, UFR de Médecine , Paris , France. 4. d d Department of General Practice , Pierre et Marie Curie University , Paris , France. 5. e e sa Novo Nordisk Pharma nv , Brussels , Belgium. 6. f f Novo Nordisk Pharmaceutique SAS , Paris , France. 7. g g Ossian Health Economics and Communications , Basel , Switzerland.
Abstract
OBJECTIVES: The present study aimed to compare the projected long-term clinical and cost implications associated with liraglutide, sitagliptin and glimepiride in patients with type 2 diabetes mellitus failing to achieve glycemic control on metformin monotherapy in France. METHODS: Clinical input data for the modeling analysis were taken from two randomized, controlled trials (LIRA-DPP4 and LEAD-2). Long-term (patient lifetime) projections of clinical outcomes and direct costs (2013 Euros; €) were made using a validated computer simulation model of type 2 diabetes. Costs were taken from published France-specific sources. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed. RESULTS: Liraglutide was associated with an increase in quality-adjusted life expectancy of 0.25 quality-adjusted life years (QALYs) and an increase in mean direct healthcare costs of €2558 per patient compared with sitagliptin. In the comparison with glimepiride, liraglutide was associated with an increase in quality-adjusted life expectancy of 0.23 QALYs and an increase in direct costs of €4695. Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio (ICER) of €10,275 per QALY gained vs sitagliptin and €20,709 per QALY gained vs glimepiride in France. CONCLUSION: Calculated ICERs for both comparisons fell below the commonly quoted willingness-to-pay threshold of €30,000 per QALY gained. Therefore, liraglutide is likely to be cost-effective vs sitagliptin and glimepiride from a healthcare payer perspective in France.
OBJECTIVES: The present study aimed to compare the projected long-term clinical and cost implications associated with liraglutide, sitagliptin and glimepiride in patients with type 2 diabetes mellitus failing to achieve glycemic control on metformin monotherapy in France. METHODS: Clinical input data for the modeling analysis were taken from two randomized, controlled trials (LIRA-DPP4 and LEAD-2). Long-term (patient lifetime) projections of clinical outcomes and direct costs (2013 Euros; €) were made using a validated computer simulation model of type 2 diabetes. Costs were taken from published France-specific sources. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed. RESULTS: Liraglutide was associated with an increase in quality-adjusted life expectancy of 0.25 quality-adjusted life years (QALYs) and an increase in mean direct healthcare costs of €2558 per patient compared with sitagliptin. In the comparison with glimepiride, liraglutide was associated with an increase in quality-adjusted life expectancy of 0.23 QALYs and an increase in direct costs of €4695. Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio (ICER) of €10,275 per QALY gained vs sitagliptin and €20,709 per QALY gained vs glimepiride in France. CONCLUSION: Calculated ICERs for both comparisons fell below the commonly quoted willingness-to-pay threshold of €30,000 per QALY gained. Therefore, liraglutide is likely to be cost-effective vs sitagliptin and glimepiride from a healthcare payer perspective in France.
Authors: Francisco J Barrera; Freddy Jk Toloza; Oscar J Ponce; Jorge A Zuñiga-Hernandez; Larry J Prokop; Nilay D Shah; Gordon Guyatt; Rene Rodriguez-Gutierrez; Victor M Montori Journal: Endocrine Date: 2020-09-21 Impact factor: 3.633
Authors: Bhavani Shankara Bagepally; Usa Chaikledkaew; Yogesh Krishnarao Gurav; Thunyarat Anothaisintawee; Sitaporn Youngkong; Nathorn Chaiyakunapruk; Mark McEvoy; John Attia; Ammarin Thakkinstian Journal: BMJ Open Diabetes Res Care Date: 2020-07