A 3 4 7 -A 7 6 6 reported clinical inputs utilised in economic models: reduction in HbA1c levels (49 studies), hypoglycaemic events (39 studies), change in BMI (30 studies), change in systolic blood pressure (SBP, 23 studies), change in body weight (19 studies), and change in lipid biomarkers (17 studies); 28 studies reported utility inputs: hypoglycaemia (20 studies), BMI (12 studies), and T2DM-related cardiovascular-(12 studies), renal-(11 studies), and eye-complications (11 studies). Six studies for SGLT-2 inhibitors considered urinary tract and genital infections (key SGLT-2 inhibitors adverse events [AEs]), which indicate increased interest in treatment-related AEs besides the regular clinical effectiveness inputs. Among assessed studies, key cost drivers for insulins were HbA1c change (9 studies), hypoglycaemia event rate (10 studies), and T2DM-related complications (5 studies). For GLP-1 analogues, key cost drivers were changes in utilities associated with weight change, BMI, and nausea. For SGLT-2 inhibitors, key cost drivers were weight/BMI change, HbA1c change, and SBP change. ConClusions: HbA1c levels and hypoglycaemic event rates dominate economic evaluations for T2DM and with T2DM-related complications were found to be key cost-drivers for insulin-based regimens. However, weight/BMI were identified as key cost-drivers for GLP-1 analogues and SGLT-2 inhibitors.objeCtives: Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodiumglucose co-transporter 2 inhibitors (SGLT-2i) are both indicated for the treatment of Type 2 diabetes mellitus (T2DM). Liraglutide and dapagliflozin are the most commonly prescribed GLP-1RA and SGLT-2i treatments in Spain, respectively. This study investigated the cost-effectiveness of liraglutide versus dapagliflozin for the treatment of T2DM in Spain. Methods: The IMS CORE Diabetes Model (CDM), a validated simulation model, was used to estimate expected costs and outcomes. Patients with T2DM who had failed prior therapy with metformin received liraglutide 1.2mg or 1.8mg as interventions versus dapagliflozin 10mg as comparator, in addition to continuing metformin (dual therapy). Comparative efficacy was extracted from a network meta-analysis. Utility inputs came from a systematic literature review. A Spanish national payer perspective was assumed and analysis run over a lifetime time horizon. Sensitivity analysis considered a cohort receiving liraglutide or dapagliflozin in combination with two other anti-diabetic drugs (triple therapy). Results: In dual therapy, liraglutide 1.2mg resulted in a QALY gain of 0.07 vs dapagliflozin 10mg at an additional cost of € 421 (ICER: € 6,486 per QALY gained), whereas results for liraglutide 1.8mg found a QALY gain of 0.08 at an additional cost of € 1,480 (ICER: € 17,966 per QALY gained). In triple therapy, QALY gain with liraglutide 1.2mg vs dapagliflozin 10mg was similar (0.07) and incremental cost was € 578 (ICER: € 8,932 per QALY gained), while increases in efficacy and costs were observed for liraglutide 1.8mg (ICER: € 17,703 per ...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.