Maurílio de Souza Cazarim1, Estael Luzia Coelho da Cruz-Cazarim2, André de Oliveira Baldoni3, Thais Bueno Enes Dos Santos4, Paula Gonçalves de Souza5, Ingrid de Almeida Silva6, Roberta Niriam Reis Rodrigues7, Alda Cristina Franco Correa Maia8, Leonardo Régis Leira Pereira9, Cristina Sanches10. 1. Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil. Electronic address: mscazarim@usp.br. 2. Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil. Electronic address: estaelcruz@fcfrp.usp.br. 3. Federal University of São João Del-Rei (UFSJ), Brazil. Electronic address: andrebaldoni@ufsj.edu.br. 4. Federal University of São João Del-Rei (UFSJ), Brazil. Electronic address: enesthais@gmail.com. 5. Federal University of São João Del-Rei (UFSJ), Brazil. Electronic address: paula.gsouza@hotmail.com. 6. Federal University of São João Del-Rei (UFSJ), Brazil. Electronic address: ingrid-almeida@hotmail.com. 7. Federal University of São João Del-Rei (UFSJ), Brazil. Electronic address: robertaniriam@gmail.com. 8. Federal University of São João Del-Rei (UFSJ), Brazil. Electronic address: aldinhamaia@hotmail.com. 9. Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil. Electronic address: lpereira@fcfrp.usp.br. 10. Federal University of São João Del-Rei (UFSJ), Brazil. Electronic address: csanches@ufsj.edu.br.
Abstract
INTRODUCTION: Type 2 diabetes mellitus (T2DM) has burdened health systems in the world to the value of 500 billion dollars/year. Dipeptidyl peptidase 4 inhibitors (DPP-4 Inhibitors) have been strongly associated with spending on the treatment of T2DM by the courts in Brazil. The aim of this study was to estimate the most cost-effective DPP-4 Inhibitor for T2DM treatment. A pharmacoeconomic study of cost-effectiveness was performed in a medium-sized municipality in Minas Gerais state, Brazil. METHODS: The data are from legalization in municipal health in 2013. The effectiveness of DPP-4 Inhibitors was measured by the reduction in glycated hemoglobin (A1c). The direct medical costs of drug and adverse drug reactions were identified. With these data, a cost-effectiveness ratio (CER) and construction of the decision tree for sensitivity analysis were performed. RESULTS: The representative of the most effective in reducing A1c gliptins was sitagliptin in combination with metformin, it was able to reduce A1c by 1.16% (1.09 to 1.22, CI 95%). The drug with the lowest cost was linagliptin, with a cost per patient/year of US$ 481.42. Sensitivity analysis performed by the decision tree shows that sitagliptin in association with metformin had the CER of US$ 1,506.75 per patient/year, to reduce A1c by 1%. CONCLUSION: The most cost-effective DPP-4 Inhibitor was sitagliptin with metformin.
INTRODUCTION:Type 2 diabetes mellitus (T2DM) has burdened health systems in the world to the value of 500 billion dollars/year. Dipeptidyl peptidase 4 inhibitors (DPP-4 Inhibitors) have been strongly associated with spending on the treatment of T2DM by the courts in Brazil. The aim of this study was to estimate the most cost-effective DPP-4 Inhibitor for T2DM treatment. A pharmacoeconomic study of cost-effectiveness was performed in a medium-sized municipality in Minas Gerais state, Brazil. METHODS: The data are from legalization in municipal health in 2013. The effectiveness of DPP-4 Inhibitors was measured by the reduction in glycated hemoglobin (A1c). The direct medical costs of drug and adverse drug reactions were identified. With these data, a cost-effectiveness ratio (CER) and construction of the decision tree for sensitivity analysis were performed. RESULTS: The representative of the most effective in reducing A1c gliptins was sitagliptin in combination with metformin, it was able to reduce A1c by 1.16% (1.09 to 1.22, CI 95%). The drug with the lowest cost was linagliptin, with a cost per patient/year of US$ 481.42. Sensitivity analysis performed by the decision tree shows that sitagliptin in association with metformin had the CER of US$ 1,506.75 per patient/year, to reduce A1c by 1%. CONCLUSION: The most cost-effective DPP-4 Inhibitor was sitagliptin with metformin.
Authors: Sanjay Kalra; Sarita Bajaj; A G Unnikrishnan; Manash P Baruah; Rakesh Sahay; V Hardik; Amit Kumar Journal: Indian J Endocrinol Metab Date: 2019 May-Jun