Significant findings were, a higher frequency of tobacco related cancers i.e., Lung cancer and Head and neck cancer in males, and screening detectable cancers (Breast and Cervix) in females. A higher frequency of Lung cancer in females was also noted as compared to previous studies. An unusually high frequency of Gall Bladder Cancers especially among the female population in this region is also a cause of concern. Our data was compared with the national data.
Objectives: Changes in body mass index (BMI) is one of the key drivers of costeffectiveness in diabetes modeling via its impact on utility. Most models are using a fixed disutility per point increase of BMI. However, it can be questioned whether decreasing BMI has the same impact on utility in overweighed and non-overweighed patients. IQVIA Core Diabetes Model (CDM) version 9.5 includes two disutility approaches: 1) fixed disutility per unit gain of BMI above a BMI of 25kg/m2 (already available in version 9.0); 2) polynomial model based on a regression analysis with a variable disutility based on the current BMI (Soltoft F, 2009). The aim of this study was to assess the impact of the two approaches on QALYs and ICER. Methods: The observational EDGE study comparing metformin+vildagliptin (M+V) versus metfor-min+sulphonylurea (M+S) was used as a base case. Basal insulin rescue therapy was applied to both arms when at an HbA1c threshold level of 7.5% was reached. Baseline characteristics and treatments effects from the published EDGE study were applied. HbA1c reductions and change in body weight were applied -0.99% -1.19% and -0.3kg -1.6kg for M+S and M+V respectively. Fixed disutility per point of BMI was the NICE approved CDM default value (0.0061). UK costs (2018) were used and annual discounting of 3.5% was applied on costs and QALYs. Results: With the polynomial approach, the lifetime QALYs were 8.147 and 8.119 for M+V and M+S respectively. When using the static approach, QALY were 7.940 and 7.896 respectively. With the new approach the ICER increased from 12,061 GBP/QALY to 19,655 GBP/QALY. Conclusions: The polynomial approach is more conservative resulting in higher total QALY in both arms, lower incrementals and thus higher ICERs compared to the static approach.
maintained treatment effect from long-term evidence in other T2DM populations. Responder were primarily defined using a composite end-point that based on an HbA1c#7.0% threshold AND no weight gain AND no documented symptomatic hypoglycemia. The NNT was calculated to determine the average number of patients needed to be treated in order to gain one additional successful responder. Sensitivity analyses were performed to examine the robustness of results. Results: For the primary composite end-point, cost per responder results were 136,290 CNY for lixisenatide group, 231,487 CNY for Basal-Plus group, and 222,424 CNY for Basal-Bolus group. The NNT analysis showed that there was approximately one additional responder for every 7.65 and 8.74 patients treated with lixisenatide combined with basal insulin compared to Basal-Plus and Basal-Bolus, respectively. The sensitivity analysis proved the robustness of results. Conclusions: Lixisenatide combined with basal insulin is a cost-effective treatment alternative compared with Basal-Plus and Basal-Bolus for T2DM patients inadequately controlled by basal insulin in China.
084) vs tofogliflozin 40mg, -1.180 (-1.201, -1.159) vs placebo. Conclusions: Canagliflozin 300 mg monotherapy was the most effective compared to other SGLT2I monotherapies for HbA1c reduction in adults with uncontrolled T2DM on diet/exercise or metformin. These results may be validated in head-to-head clinical studies, if feasible.
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