Cost-Effectiveness of Saxagliptin Versus Acarbose as Second-Line Therapy in Type 2 Diabetes in China

Abstract

ObjectiveThis study assessed the long-term cost-effectiveness of saxagliptin+metformin (SAXA +MET) versus acarbose+metformin (ACAR+MET) in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled on MET alone. MethodsSystematic literature reviews were performed to identify studies directly comparing SAXA +MET versus ACAR+MET, and to obtain diabetes-related events costs which were modified by hospital surveys. A Cardiff Diabetes Model was used to estimate the long-term economic and health treatment consequences in patients with T2DM. Costs (2014 Chinese yuan) were calculated from the payer's perspective and estimated over a patient's lifetime. ResultsSAXA+MET predicted lower incidences of most cardiovascular events, hypoglycemia events and fatal events, and decreased total costs compared with ACAR+MET. For an individual patient, the quality-adjusted life-years (QALYs) gained with SAXA+MET was 0.48 more than ACAR+MET at a cost saving of ¥18,736, which resulted in a cost saving of ¥38,640 per QALY gained for SAXA+MET versus ACAR+MET. Results were robust across various univariate and probabilistic sensitivity analyses. ConclusionSAXA+MET is a cost-effective treatment alternative compared with ACAR+MET for patients with T2DM in China, with a little QALYs gain and lower costs. SAXA is an effective, well-tolerated drug with a low incidence of adverse events and ease of administration; it is anticipated to be an effective second-line therapy for T2DM treatment.

Comparative effect of saxagliptin and glimepiride with a composite endpoint of adequate glycaemic control without hypoglycaemia and without weight gain in patients uncontrolled with metformin therapy: Results from the SPECIFY study, a 48‐week, multi‐centre, randomized, controlled trial

“…Additionally, at Week 48, early-phase insulin secretion was higher with glimepiride than with saxagliptin. DI 30 and DI 120 were significantly increased in both treatment groups after 48 weeks of treatment vs baseline, and no difference was observed between the two groups. In addition, there was no difference in HOMA-IR and ISI m between baseline and Week 48 in either the saxagliptin or glimepiride treatment group (Table 2).…”

“…As RCTs are pre-designed, the participants enrolled are followed up during a short-term period, and medication costs are generally It is noteworthy that several retrospective studies, based on data from the literature search or on hospital surveys from different countries, demonstrate that metformin+DPP-4i treatment is cost-effective compared to metformin+SU treatment as long-term dual therapy in T2D, including the costs associated with hypoglycaemia, weight gain and complications. [28][29][30][31] We tried to calculate medication expenditure according to patient compliance in our study. Total drug expenditure over 48 weeks of treatment in the saxagliptin (Onglyza) group (¥2824) was 1.6-fold that in the glimepiride (Amaryl) group (¥1772), with comparable improvement in glycaemic control.…”