Switching from sitagliptin to liraglutide to manage patients with type 2 diabetes in the UK: A long‐term cost‐effectiveness analysis

Barnett, Anthony; Arnoldini, Simon; Hunt, Barnaby; Subramanian, Gowri; Hoxer, Christina Stentoft

doi:10.1111/dom.13318

Cited by 9 publications

(8 citation statements)

References 27 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Empagliflozin and canagliflozin have both demonstrated cost-effectiveness vs. comparators in the UK [62][63][64]. Several studies of liraglutide in the UK have also concluded costeffectiveness, despite increased acquisition cost, due to reduction in diabetes-related complications [65][66][67]. However, cost-effectiveness analyses evaluate drugs as glucoselowering entities, and modelling is therefore based on traditional risk equations [68][69][70][71], which do not capture potential cardiovascular benefits [72].…”

Section: Therapy Choices Based On Cost-effectiveness Analysesmentioning

confidence: 99%

Pharmacological treatment for Type 2 diabetes integrating findings from cardiovascular outcome trials: an expert consensus in the UK

et al. 2019

View full text Add to dashboard Cite

In people with Type 2 diabetes, cardiovascular disease is a leading cause of morbidity and mortality. Thus, as well as controlling glucose, reducing the risk of cardiovascular events is a key goal. The results of cardiovascular outcome trials have led to updates for many national and international guidelines. England, Wales and Northern Ireland remain exceptions, with the most recent update to the National Institute for Health and Care Excellence (NICE) guidelines published in 2015. We reviewed current national and international guidelines and recommendations on the management of people with Type 2 diabetes. This article shares our consensus on clinical recommendations for the use of sodium‐glucose co‐transporter 2 inhibitors (SGLT‐2is) and glucagon‐like peptide 1 receptor agonists (GLP‐1RAs) in people with Type 2 diabetes and established or at very high risk of cardiovascular disease in the UK. We also consider cost‐effectiveness for these therapies. We recommend considering each person's cardiovascular risk and using diabetes therapies with proven cardiovascular benefits when appropriate to improve long‐term outcomes and cost‐effectiveness.

show abstract

Section: Therapy Choices Based On Cost-effectiveness Analysesmentioning

confidence: 99%

Pharmacological treatment for Type 2 diabetes integrating findings from cardiovascular outcome trials: an expert consensus in the UK

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Of the 864 identified studies, 56 studies were eligible for the meta-analysis (see figure 1). From the 56 studies, 82 comparisons were assessed, including GLP1 versus DPP4i (n=10) [18][19][20][21][22][23][24][25][26][27] ; GLP1 versus sulfonylureas (n=7) 20 25-30 ; GLP1 versus thiazolidines (n=3) 21 30 31 ; GLP1 versus insulins (n=27, 23 HICs 19 30-52 and 3 UMICs [53][54][55] ); GLP1 versus insulin plus DPP4i (n=2), 45 56 or insulin plus sulfonylureas (n=2), 52 57 GLP1 versus insulin plus GLP1 (n=5) 36 42 46 55 58 and insulin degludec/liraglutide (IDeg-Lira) versus insulin (n=7). 34-36 42 46 48 59 Among GLP1s, treatment comparisons included liraglutide versus exenatide (n=7) 43 56 60-64 and liraglutide versus lixisenatide (n=5).…”

Section: Resultsmentioning

confidence: 99%

“…INBs of GLP1 versus DPP4i were estimated (n=10 [18][19][20][21][22][23][24][25][26][27] ), and all were from HICs with no heterogeneity (I 2 =0, figure 2A). The INB p was US$4012.21 (95% CI US$−571.43 to US$8595.84), which favours GLP1 compared with DPP4i, but does not reach statistical significance.…”

Section: Glp1 Versus Dpp4imentioning

confidence: 99%

Glucagon-like peptide 1 agonists for treatment of patients with type 2 diabetes who fail metformin monotherapy: systematic review and meta-analysis of economic evaluation studies

Bagepally

Chaikledkaew

Gurav

et al. 2020

BMJ Open Diab Res Care

View full text Add to dashboard Cite

ObjectivesTo conduct a systematic review and meta-analysis and to pool the incremental net benefits (INBs) of glucagon-like peptide 1 (GLP1) compared with other therapies in type 2 diabetes mellitus (T2DM) after metformin monotherapy failure.Research design and methodsThe study design is a systematic review and meta-analysis. We searched MEDLINE (via PubMed), Scopus and Tufts Registry for eligible cost–utility studies up to June 2018, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. We conducted a systematic review and pooled the INBs of GLP1s compared with other therapies in T2DM after metformin monotherapy failure. Various monetary units were converted to purchasing power parity, adjusted to 2017 US$. The INBs were calculated and then pooled across studies, stratified by level of country income; a random-effects model was used if heterogeneity was present, and a fixed-effects model if it was absent. Heterogeneity was assessed using Q test and I2 statistic.ResultsA total of 56 studies were eligible, mainly from high-income countries (HICs). The pooled INBs of GLP1s compared with dipeptidyl peptidase-4 inhibitor (DPP4i) (n=10), sulfonylureas (n=6), thiazolidinedione (TZD) (n=3), and insulin (n=23) from HICs were US$4012.21 (95% CI US$−571.43 to US$8595.84, I2=0%), US$3857.34 (95% CI US$−7293.93 to US$15 008.61, I2=45.9%), US$37 577.74 (95% CI US$−649.02 to US$75 804.50, I2=92.4%) and US$14 062.42 (95% CI US$8168.69 to US$19 956.15, I2=86.4%), respectively. GLP1s were statistically significantly cost-effective compared with insulins, but not compared with DPP4i, sulfonylureas, and TZDs. Among GLP1s, liraglutide was more cost-effective compared with lixisenatide, but not compared with exenatide, with corresponding pooled INBs of US$4555.09 (95% CI US$3992.60 to US$5117.59, I2=0) and US$728.46 (95% CI US$−1436.14 to US$2893.07, I2=0), respectively.ConclusionGLP1 agonists are a cost-effective choice compared with insulins, but not compared with DPP4i, sulfonylureas and TZDs.PROSPERO registration numberCRD42018105193.

show abstract

“…Overall, 38 studies reporting health economic analysis of antidiabetic medications were included, with one study reporting evaluations for three countries of interest [ 30 , 51 , 70 – 105 ]. Of the 40 evaluations, most were for the UK ( n = 23), followed by Spain ( n = 9) and Italy ( n = 4), with two each from France and Germany.…”

Section: Resultsmentioning

confidence: 99%

Costs and where to find them: identifying unit costs for health economic evaluations of diabetes in France, Germany and Italy

Pöhlmann¹,

Norrbacka²,

Boye

et al. 2020

Eur J Health Econ

View full text Add to dashboard Cite

Background Health economic evaluations require cost data as key inputs. Many countries do not have standardized reference costs so costs used often vary between studies, thereby reducing transparency and transferability. The present review provided a comprehensive overview of cost sources and suggested unit costs for France, Germany and Italy, to support health economic evaluations in these countries, particularly in the field of diabetes. Methods A literature review was conducted across multiple databases to identify published unit costs and cost data sources for resource items commonly used in health economic evaluations of antidiabetic therapies. The quality of unit cost reporting was assessed with regard to comprehensiveness of cost reporting and referencing as well as accessibility of cost sources from published cost-effectiveness analyses (CEA) of antidiabetic medications. Results An overview of cost sources, including tariff and fee schedules as well as published estimates, was developed for France, Germany and Italy, covering primary and specialist outpatient care, emergency care, hospital treatment, pharmacy costs and lost productivity. Based on these sources, unit cost datasets were suggested for each country. The assessment of unit cost reporting showed that only 60% and 40% of CEAs reported unit costs and referenced them for all pharmacy items, respectively. Less than 20% of CEAs obtained all pharmacy costs from publicly available sources. Conclusions This review provides a comprehensive account of available costs and cost sources in France, Germany and Italy to support health economists and increase transparency in health economic evaluations in diabetes.

show abstract

Switching from sitagliptin to liraglutide to manage patients with type 2 diabetes in the UK: A long‐term cost‐effectiveness analysis

Abstract: Switching from sitagliptin 100 mg to liraglutide 1.8 mg in patients with poor glycaemic control was projected to improve clinical outcomes and is likely to be considered cost-effective in the UK setting and, therefore, a good use of limited NHS resources.

Cited by 9 publications

References 27 publications

Pharmacological treatment for Type 2 diabetes integrating findings from cardiovascular outcome trials: an expert consensus in the UK

Pharmacological treatment for Type 2 diabetes integrating findings from cardiovascular outcome trials: an expert consensus in the UK

Glucagon-like peptide 1 agonists for treatment of patients with type 2 diabetes who fail metformin monotherapy: systematic review and meta-analysis of economic evaluation studies

Costs and where to find them: identifying unit costs for health economic evaluations of diabetes in France, Germany and Italy

Contact Info

Product

Resources

About