Cost-effectiveness of add-on treatments to metformin in a Swedish setting: liraglutide vs sulphonylurea or sitagplitin

Carlsson, Katarina Steen; Persson, Ulf

doi:10.3111/13696998.2014.933110

Cited by 23 publications

(37 citation statements)

References 24 publications

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“…The validation indicated that the model has a predictive accuracy in line with other models of T2D. This model is applicable to CEAs of diabetes in Sweden as it is based on Swedish risks, healthcare system, and costs [27][28][29] .…”

Section: Paɵents Inadequately Controlled On Meƞormin Paɵents Inadequamentioning

confidence: 56%

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Cost-effectiveness of once-weekly semaglutide versus dulaglutide and lixisenatide in patients with type 2 diabetes with inadequate glycemic control in Sweden

Ericsson¹,

Fridhammar

2019

Journal of Medical Economics

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Aims: This analysis evaluated the cost-effectiveness of once-weekly semaglutide vs glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes (T2D) uncontrolled on metformin or basal insulin in Sweden. Materials and methods: This cost-effectiveness analysis (CEA) was conducted using the Swedish Institute of Health Economics (IHE) Diabetes Cohort Model. Analyses were conducted from the Swedish societal perspective over a time horizon of 40 years. For patients uncontrolled on metformin, dulaglutide was the comparator, and data from the SUSTAIN 7 clinical trial was used. For patients uncontrolled on basal insulin, lixisenatide was chosen as the comparator and data was obtained from a network meta-analysis (NMA). Results: The results show that, in patients with inadequate control on metformin, semaglutide 1.0 mg dominated (i.e. provided greater clinical benefit, and was less costly) dulaglutide 1.5 mg. In patients with inadequate control on basal insulin, semaglutide 1.0 mg dominated lixisenatide. The reduction in costs is largely driven by the reduction in complications seen with once-weekly semaglutide. Limitations and conclusions: It is likely that this analysis is conservative in estimating the cardiovascular (CV) cost benefits associated with treatment with once-weekly semaglutide. In patients inadequately controlled on basal insulin, the analyses vs lixisenatide were based on results from an NMA, as no head-to-head clinical trial has been conducted for this comparison. These CEA results show that once-weekly semaglutide is a cost-effective GLP-1 RA therapy for the treatment of T2D in patients inadequately controlled on metformin or basal insulin, addressing many current clinician, patient, and payer unmet needs in Sweden. ARTICLE HISTORY

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Section: Paɵents Inadequately Controlled On Meƞormin Paɵents Inadequamentioning

confidence: 56%

“…These CEAs were conducted using the IHE Diabetes Cohort Model 26 , which has been used in other CEAs in Sweden [27][28][29] . Briefly, this model uses cohort simulation to estimate the cost-effectiveness of competing interventions for T2D.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of once-weekly semaglutide versus dulaglutide and lixisenatide in patients with type 2 diabetes with inadequate glycemic control in Sweden

Ericsson¹,

Fridhammar

2019

Journal of Medical Economics

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“…The external validation of the model was tested by simulating 12 clinical trials (both interventional and non-interventional) and comparing 167 predicted microvascular, macrovascular and mortality outcomes with those observed in the actual trials [24]. Moreover, the model has been used for several analyses, both in health economic publications [40, 45] and in the development of new national diabetes guidelines [6]. …”

Section: Discussionmentioning

confidence: 99%

“…heart failure, stroke, etc.) were identified from a published Swedish cost-effectiveness analysis (Table S1 in the ESM) [40] and adjusted for inflation to 2013 monetary values. The analysis also included indirect costs of diabetes-related complications.…”

Section: Methodsmentioning

confidence: 99%

Cost Effectiveness of Insulin Degludec Plus Liraglutide (IDegLira) in a Fixed Combination for Uncontrolled Type 2 Diabetes Mellitus in Sweden

Ericsson¹,

Lundqvist

2017

Appl Health Econ Health Policy

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BackgroundPatients with uncontrolled type 2 diabetes mellitus (T2DM) are a priority group for intensified therapy without weight gain and with low risk of hypoglycaemia.ObjectiveThis study evaluates the cost effectiveness of insulin degludec plus liraglutide (IDegLira, Xultophy®) compared with six potential intensification treatment options for patients with T2DM that is uncontrolled with basal insulin.MethodsThe Swedish Institute for Health Economics (IHE) Cohort Model of Type 2 Diabetes was used with Swedish input data, a 40-year time frame and a societal perspective. The comparators for treatment intensification included insulin glargine, neutral protamine Hagedorn (NPH) insulin, insulin aspart plus either glargine or NPH, and liraglutide plus either glargine or NPH. Clinical data for all comparators (except NPH insulin) were based on an indirect treatment comparison of several studies. Prices were obtained from the 2014 Swedish Dental and Pharmaceutical Benefits Agency (Tandvårds- och läkemedelsförmånsverket [TLV]) database, and utility values were obtained from published studies. Sensitivity analyses were undertaken.ResultsOverall incremental cost-effectiveness ratios (ICER) were Swedish krona (SEK) 70,000 or lower per quality-adjusted life-year (QALY). IDegLira compared with intensified basal insulin showed an ICER of SEK 28,000 per QALY versus insulin glargine, SEK70,000 per QALY versus NPH insulin and SEK 60,000 per QALY versus NPH insulin plus liraglutide. IDegLira was dominant over insulin glargine plus liraglutide and insulin aspart plus insulin glargine or NPH insulin. Results were driven by the difference in glycated haemoglobin (HbA1c) reduction between treatments, as confirmed by sensitivity analyses.ConclusionsIDegLira is estimated to be a cost-effective treatment in Sweden compared with commonly used intensification treatments for patients with T2DM uncontrolled with basal insulin.Electronic supplementary materialThe online version of this article (doi:10.1007/s40258-016-0301-y) contains supplementary material, which is available to authorized users.

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“…34 The results were not conclusive for the a GLP-1. 20,21,23,25,33, Albiglutide appeared to be a more cost-effective option than sitagliptin, 35 but the results were the opposite when comparing the general subgroups to which these NIADs belonged (aGLP-1 versus iDPP-4). 20 Exenatide was a more cost-effective treatment than another analogue such as lixisenatide (ICER of €12,600/QALY), 36 but no conclusive results were obtained in comparison with other analogues such as liraglutide, [36][37][38][39][40][41] or dulaglutide.…”

Section: Quality Of the Studiesmentioning

confidence: 97%

A systematic review of economic evaluations in non-insulin antidiabetic treatments for patients with type 2 diabetes mellitus

Zozaya

Capel

Simón

et al. 2019

Global & Regional Health Technology Assessment

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The approval of new non-insulin treatments has broadened the therapeutic arsenal, but it has also increased the complexity of choice for the treatment of type 2 diabetes mellitus (DM2). The objective of this study was to systematically review the literature on economic evaluations associated with non-insulin antidiabetic drugs (NIADs) for DM2. We searched in Medline, IBECS, Doyma and SciELO databases for full economic evaluations of NIADs in adults with DM2 applied after the failure of the first line of pharmacological treatment, published between 2010 and 2017, focusing on studies that incorporated quality-adjusted life years (QALYs). The review included a total of 57 studies, in which 134 comparisons were made between NIADs. Under an acceptability threshold of 25,000 euros per QALY gained, iSLGT-2 were preferable to iDPP-4 and sulfonylureas in terms of incremental cost-utility. By contrast, there were no conclusive comparative results for the other two new NIAD groups (GLP-1 and iDPP-4). The heterogeneity of the studies’ methodologies and results hindered our ability to determine under what specific clinical assumptions some NIADs would be more cost-effective than others. Economic evaluations of healthcare should be used as part of the decision-making process, so multifactorial therapeutic management strategies should be established based on the patients’ clinical characteristics and preferences as principal criteria.

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Cost-effectiveness of add-on treatments to metformin in a Swedish setting: liraglutide vs sulphonylurea or sitagplitin

Abstract: Treatment strategies with liraglutide 1.2 mg improved the expected quality-of-life and increased costs when compared to SU and to sitagliptin for second-line add-on treatments. The cost per QALY for liraglutide was in the range considered medium by Swedish authorities.

Cited by 23 publications

References 24 publications

Cost-effectiveness of once-weekly semaglutide versus dulaglutide and lixisenatide in patients with type 2 diabetes with inadequate glycemic control in Sweden

Cost-effectiveness of once-weekly semaglutide versus dulaglutide and lixisenatide in patients with type 2 diabetes with inadequate glycemic control in Sweden

Cost Effectiveness of Insulin Degludec Plus Liraglutide (IDegLira) in a Fixed Combination for Uncontrolled Type 2 Diabetes Mellitus in Sweden

A systematic review of economic evaluations in non-insulin antidiabetic treatments for patients with type 2 diabetes mellitus

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