Cost-Effectiveness of Dulaglutide Versus Liraglutide for Management of Type 2 Diabetes Mellitus in Iran

Ekhlasi, Mahna; Taheri, Saeed; Yousefi, Nazila

doi:10.1016/j.vhri.2022.07.005

Cited by 2 publications

(11 citation statements)

References 40 publications

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“…The majority of studies (n = 30) were conducted in Europe , of which many were conducted in the UK (n = 9) [37,38,40,45,46,48,51,57,62], and one-third of the studies were conducted in North America (n = 10) [64][65][66][67][68][69][70][71][72][73] and Asia (n = 8) [74][75][76][77][78][79][80][81]. Two studies were conducted outside these regions: one each from Colombia [82] and Iran [83].…”

Section: Basic Characteristicsmentioning

confidence: 99%

“…One study used both the IHE-DCM and the ECHO-T2DM to produce and compare their results [73]. Eight studies did not state the model name, of which three studies [71,80,83] used Markov state transition models, three used individual patient simulations [55,67,72], and one each used a state transition cohort model with a competing risk approach [70] and a decision tree [65].…”

Section: Basic Characteristicsmentioning

confidence: 99%

“…The majority had a time horizon of either 40 years (n = 12) [34-36, 44, 50, 54, 60, 68, 73, 75, 79, 81] or 50 years (n = 21) [37-42, 45-49, 51, 52, 56, 58, 59, 61-63, 76, 77], while some studies (n = 11) reported a lifetime horizon [43,53,55,57,64,67,69,70,72,74,78]. The remainder had a time horizon of 30 years [66] or 10 years [80,83].…”

Section: Basic Characteristicsmentioning

confidence: 99%

“…Two studies had unclear reporting on the background medication [71,80]. With regard to combination therapy, most studies (n = 22) involved dual or triple therapy, while some studies (n = 19) had dual therapy and the remaining eight studies had triple therapy or above [36,54,59,69,72,75,76,83]. In one study, the background medication was unclear [80].…”

Section: Basic Characteristicsmentioning

confidence: 99%

“…In the one study where oral semaglutide was compared with injectable semaglutide, oral semaglutide was dominant against it and all other comparators [70]. The three remaining comparisons were between other GLP1 products and gave conflicting results [36,50,83]. For the six comparisons with GLP1 and other classes as comparators, injectable semaglutide was dominant compared with dulaglutide and sitagliptin [47], and cost-effective compared with insulin glargine [43].…”

Section: Glucagon-like Peptide-1 (Glp1) Compared With Glp1 or Another...mentioning

confidence: 99%

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A Systematic Review of Cost-Effectiveness Studies of Newer Non-Insulin Antidiabetic Drugs: Trends in Decision-Analytical Models for Modelling of Type 2 Diabetes Mellitus

Laursen

Jørgensen²,

Vestergaard

et al. 2023

PharmacoEconomics

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Background We performed a systematic overview of the cost-effectiveness analyses (CEAs) comparing non-insulin antidiabetic drugs (NIADs) with other NIADs for the treatment of type 2 diabetes mellitus (T2DM), using decision-analytical modelling (DAM), focusing on both the economic results and the underlying methodological choices. Methods Eligible studies were CEAs using DAM to compare NIADs within the glucagon-like peptide-1 (GLP1) receptor agonists, sodium-glucose cotransporter-2 (SGLT2) inhibitors, or dipeptidyl peptidase-4 (DPP4) inhibitor classes with other NIADs within those classes for the treatment of T2DM. The PubMed, Embase and Econlit databases were searched from 1 January 2018 to 15 November 2022. Two reviewers screened the studies for relevance by titles and abstracts and then for eligibility via full-text screening, extracted the data from the full texts and appendices, and then stored the data in a spreadsheet. ResultsThe search yielded 890 records and 50 studies were eligible for inclusion. The studies were mainly based on a European setting (60%). Industry sponsorship was found in 82% of studies. The CORE diabetes model was used in 48% of the studies. GLP1 and SGLT2 products were the main comparators in 31 and 16 studies, respectively, while one study had DPP4 and two had no easily discernible main comparator. Direct comparison between SGLT2 and GLP1 occurred in 19 studies. At a class level, SGLT2 dominated GLP1 in six studies and was cost effective against GLP1 once as part of a treatment pathway. GLP1 was cost effective in nine studies and not cost effective against SGLT2 in three studies. At a product level, oral and injectable semaglutide, and empagliflozin, were cost effective against other within-class products. Injectable and oral semaglutide were more frequently found cost effective in these comparisons, with some conflicting results. Most of the modelled cohorts and treatment effects were sourced from randomised controlled trials. The following model assumptions varied depending on the class of the main comparator: choice of and reasoning behind risk equations, the time until the treatment switch, and how often the comparators were discontinued. Diabetes-related complications were emphasised on par with quality-adjusted life-years as model outputs. The main quality issues were regarding the description of alternatives, the perspective of analysis, the measurement of costs and consequences, and patient subgroups. Conclusion The included CEAs using DAMs have limitations that hinder their ability to inform decision makers on the cost-effective choice: lack of updated reasoning behind the choice of key model assumptions, over-reliance on risk equations based on older treatment practices, and sponsorship bias. The question of which NIAD is cost effective for the treatment of which T2DM patient is a pressing one and the answer remains unclear. 1471 Cost-Effectiveness Studies Comparing Non-Insulin Pharmaceuticals for T2DM 2 Methods This systematic review was conducted in 2021, updated in 2022, a...

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Section: Basic Characteristicsmentioning

confidence: 99%

Section: Basic Characteristicsmentioning

confidence: 99%

Section: Basic Characteristicsmentioning

confidence: 99%

Section: Basic Characteristicsmentioning

confidence: 99%

Section: Glucagon-like Peptide-1 (Glp1) Compared With Glp1 or Another...mentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of Cost-Effectiveness Studies of Newer Non-Insulin Antidiabetic Drugs: Trends in Decision-Analytical Models for Modelling of Type 2 Diabetes Mellitus

Laursen

Jørgensen²,

Vestergaard

et al. 2023

PharmacoEconomics

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Adverse drug events in cost-effectiveness models of pharmacological interventions for diabetes, diabetic retinopathy, and diabetic macular edema: a scoping review

Pesonen,

Jylhä,

Kankaanpää

2024

JBI Evidence Synthesis

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Objective: The objective of this review was to examine the role of adverse drug events (ADEs) caused by pharmacological interventions in cost-effectiveness models for diabetes mellitus, diabetic retinopathy, and diabetic macular edema. Introduction: Guidelines for economic evaluation recognize the importance of including ADEs in the analysis, but in practice, consideration of ADEs in cost-effectiveness models seem to be vague. Inadequate inclusion of these harmful outcomes affects the reliability of the results, and the information provided by economic evaluation could be misleading. Reviewing whether and how ADEs are incorporated in cost-effectiveness models is necessary to understand the current practices of economic evaluation. Inclusion criteria: Studies included were published between 2011–2022 in English, representing cost-effectiveness analyses using modeling framework for pharmacological interventions in the treatment of diabetes mellitus, diabetic retinopathy, or diabetic macular edema. Other types of analyses and other types of conditions were excluded. Methods: The databases searched included MEDLINE (PubMed), CINAHL (EBSCOhost), Scopus, Web of Science Core Collection, and NHS Economic Evaluation Database. Gray literature was searched via the National Institute for Health and Care Excellence, European Network for Health Technology Assessment, the National Institute for Health and Care Research, and the International Network of Agencies for Health Technology Assessment. The search was conducted on January 1, 2023. Titles and abstracts were screened for inclusion by 2 independent reviewers. Full-text review was conducted by 3 independent reviewers. A data extraction form was used to extract and analyze the data. Results were presented in tabular format with a narrative summary, and discussed in the context of existing literature and guidelines. Results: A total of 242 reports were extracted and analyzed in this scoping review. For the included analyses, type 2 diabetes was the most common disease (86%) followed by type 1 diabetes (10%), diabetic macular edema (9%), and diabetic retinopathy (0.4%). The majority of the included analyses used a health care payer perspective (88%) and had a time horizon of 30 years or more (75%). The most common model type was a simulation model (57%), followed by a Markov simulation model (18%). Of the included cost-effectiveness analyses, 26% included ADEs in the modeling, and 13% of the analyses excluded them. Most of the analyses (61%) partly considered ADEs; that is, only 1 or 2 ADEs were included. No difference in overall inclusion of ADEs between the different conditions existed, but the models for diabetic retinopathy and diabetic macular edema more often omitted the ADE-related impact on quality of life compared with the models for diabetes mellitus. Most analyses included ADEs in the models as probabilities (55%) or as a submodel (40%), and the most common source for ADE incidences were clinical trials (65%). Conclusions: The inclusion of ADEs in cost-effectiveness models is suboptimal. The ADE-related costs were better captured than the ADE-related impact on quality of life, which was most pronounced in the models for diabetic retinopathy and diabetic macular edema. Future research should investigate the potential impact of ADEs on the results, and identify the criteria and policies for practical inclusion of ADEs in economic evaluation.

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Cost-Effectiveness of Dulaglutide Versus Liraglutide for Management of Type 2 Diabetes Mellitus in Iran

Cited by 2 publications

References 40 publications

A Systematic Review of Cost-Effectiveness Studies of Newer Non-Insulin Antidiabetic Drugs: Trends in Decision-Analytical Models for Modelling of Type 2 Diabetes Mellitus

A Systematic Review of Cost-Effectiveness Studies of Newer Non-Insulin Antidiabetic Drugs: Trends in Decision-Analytical Models for Modelling of Type 2 Diabetes Mellitus

Adverse drug events in cost-effectiveness models of pharmacological interventions for diabetes, diabetic retinopathy, and diabetic macular edema: a scoping review

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