Cost–Effectiveness Analysis of Dapagliflozin Plus Standard Treatment for Patients With Type 2 Diabetes and High Risk of Cardiovascular Disease in China

Huang, Kaiyu; Wang, Yao; Sun, Sijia; Zhu, Qian; Zhou, Wei-Feng; Liu, Jiatao; Zhu, Dongchun; Xie, Xuefeng

doi:10.3389/fpubh.2022.936703

Cited by 4 publications

(2 citation statements)

References 36 publications

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“…Finally, diabetes is a chronic disease, and the incremental QALYs brought by hypoglycemic agents are generally not large. A recent long-term cost-effectiveness study suggested that Dapagliflozin plus standard treatment was anticipated to produce an additional 0.25 QALYs in comparison to standard treatment ( 31 ). Another cost-effectiveness analysis of iGlarLixi (insulin glargine 100 U/mL plus lixisenatide) vs. iDegLira (insulin degludec plus liraglutide) demonstrated an incremental QALY of 0.015 ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of insulin degludec/insulin aspart versus biphasic insulin aspart in Chinese population with type 2 diabetes

Luo

Li²,

Zhou³

et al. 2022

Front. Public Health

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ObjectiveTo evaluate the long-term cost effectiveness of insulin degludec/insulin aspart (IDegAsp) vs. biphasic insulin aspart 30 (BIAsp 30) for the treatment of people with type 2 diabetes mellitus (T2DM) inadequately managed on basal insulin in China.MethodsThe CORE (the Center for Outcomes Research) Diabetes Model, which has been published and verified, was used to simulate disease progression and calculate the total direct medical costs, life years (LYs) and quality-adjusted life years (QALYs) over 30 years, from the perspective of Chinese healthcare system. The patient demographic information and clinical data needed for the model were gathered from a phase III treat-to-target clinical trial (NCT02762578) and other Chinese cohort studies. Medical costs on treating diabetes were calculated based on clinical trial and local sources. The diabetes management and complications costs were derived from published literature. A discounting rate of 5% was applied to both health and cost outcomes. And one-way and probabilistic sensitivity analyses were carried out to test the reliability of the results.ResultsCompared with BIAsp 30, treatment with IDegAsp was associated with an incremental benefit of 0.001 LYs (12.439 vs. 12.438) and 0.280 QALYs (9.522 vs. 9.242) over a 30-year time horizon, and increased CNY (Chinese Yuan) 3,888 (390,152 vs. 386,264) for total costs. IDegAsp was cost-effective vs. BIAsp 30 therapy with an incremental cost-effectiveness ratio of CNY 13,886 per QALY gained. Results were robust across a range of sensitivity analyses.ConclusionCompared with BIAsp 30, IDegAsp was a cost-effective treatment option for people with T2DM with inadequate glycemic management on basal insulin in China.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of insulin degludec/insulin aspart versus biphasic insulin aspart in Chinese population with type 2 diabetes

Luo

Li²,

Zhou³

et al. 2022

Front. Public Health

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“…All three T1DM models identified in the systematic review are microsimulation models [34,36,50]. From the 26 T2DM models, 14 are cohort Markov models [31,33,39,41,45,[51][52][53][54][55][56][57][58][59], 11 are patient-level microsimulation models [30,32,35,37,38,40,[42][43][44][47][48][49], and 1 is a patient-level discrete-event models [46]. One model developed for T1DM and T2DM is a…”

Section: Model Structurementioning

confidence: 99%

A Systematic Review of Methodologies Used in Models of the Treatment of Diabetes Mellitus

Antoniou,

Mateus,

Hollingsworth

et al. 2023

PharmacoEconomics

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Statements and DeclarationsAuthors' contributions MA: conceptualization and design, literature search and selection, quality assessment of included studies, data extraction, statistical analysis and interpretation of data, drafted and reviewed the manuscript. CM: conceptualization and design, reviewed the data, drafted and reviewed the manuscript. BH: conceptualization and design, reviewed and revised the manuscript. AT: reviewed the data generated, reviewed and revised the manuscript.

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Cost-effectiveness of screening for chronic kidney disease in the general adult population: a systematic review

Yeo

Wang

Ang³

et al. 2023

Clinical Kidney Journal

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Introduction Chronic kidney disease (CKD) is a significant public health problem, with rising incidence and prevalence worldwide and is associated with increased morbidity and mortality. Early identification and treatment of CKD can slow its progression and prevent complications, but it is not clear if CKD screening is cost-effective. The aim of this study is to conduct a systematic review of the cost-effectiveness of CKD screening strategies in general adult populations worldwide, and to identify factors, settings and drivers of cost-effectiveness in CKD screening. Methods Studies examining the cost-effectiveness of CKD screening in general adult population were identified by systematic literature search on electronic databases (MEDLINE OVID, Embase, Cochrane Library and Web of Science) for peer-reviewed publications, hand-searched reference lists and grey literature of relevant sites, focusing on the following themes: (i) CKD, (ii) screening and (iii) cost-effectiveness. Studies comprising of health economic evaluations performed for CKD screening strategies, compared against no CKD screening or usual-care strategy in adult individuals, were included. Study characteristics, model assumptions and CKD screening strategies of selected studies were identified. The primary outcome of interest is the incremental cost-effectiveness ratio (ICER) of CKD screening, in cost per quality-adjusted life year (QALY) and life-year gained (LYG), expressed in 2022 US dollars equivalent. Results 21 studies were identified, examining CKD screening in general and targeted populations. The cost-effectiveness of screening for CKD was found to vary widely across different studies, with ICERs ranging from ${\$}$113 to ${\$}$430 595, with a median of ${\$}$26 662 per QALY and from ${\$}$6516 to ${\$}$38 372, with a median of ${\$}$29 112 per LYG. Based on the pre-defined cost-effectiveness threshold of ${\$}$50 000 per QALY, majority of the studies found CKD screening to be cost-effective. CKD screening was especially cost-effective in those with diabetes (${\$}$113 to ${\$}$42 359, with median of ${\$}$27 471 per QALY) and ethnic groups identified to be higher risk of CKD development or progression (${\$}$23 902 per QALY in African American adults and ${\$}$21 285 per QALY in Canadian indigenous adults), as indicated by a lower ICER. Additionally, the cost-effectiveness of CKD screening improved if it was performed in older adults, population with higher CKD risk-scores, setting higher albuminuria detection threshold or when increasing the interval between screening. In contrast, CKD screening was not cost-effective in population without diabetes and hypertension (ICERs range from ${\$}$117 769 to ${\$}$1792 142, with a median of ${\$}$202 761 per QALY). Treatment effectiveness, prevalence of CKD, cost of CKD treatment and discount rate were identified to be the most common influential drivers of the ICERs. Conclusions Screening for CKD is especially cost-effective in patients with diabetes and high-risk ethnic groups, but not in population without diabetes and hypertension. Increasing the age of screening, screening interval, albuminuria detection threshold or selection of population based on CKD risk-scores may increase cost-effectiveness of CKD screening, while treatment effectiveness, prevalence of CKD, cost of CKD treatment and discount rate were influential drivers of the cost-effectiveness.

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Cost–Effectiveness Analysis of Dapagliflozin Plus Standard Treatment for Patients With Type 2 Diabetes and High Risk of Cardiovascular Disease in China

Cited by 4 publications

References 36 publications

Cost-effectiveness of insulin degludec/insulin aspart versus biphasic insulin aspart in Chinese population with type 2 diabetes

Cost-effectiveness of insulin degludec/insulin aspart versus biphasic insulin aspart in Chinese population with type 2 diabetes

A Systematic Review of Methodologies Used in Models of the Treatment of Diabetes Mellitus

Cost-effectiveness of screening for chronic kidney disease in the general adult population: a systematic review

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