Comparison of healthcare resource utilization and costs in patients with type 2 diabetes initiating dapagliflozin versus sitagliptin

Parker, Emily D.; Wittbrodt, Eric; McPheeters, Jeffrey; Frías, Juan P.

doi:10.1111/dom.13502

Cited by 7 publications

(11 citation statements)

References 26 publications

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Section: Discussionsupporting

confidence: 64%

“…They also concluded that the lower hospital healthcare cost associated with dapagliflozin treatment was offset by the higher drug costs . The present study evaluated a larger, well‐matched population (based on 96 clinical and cost variables at baseline, using propensity score matching) with a longer duration of follow‐up, thus providing important additional detailsed insights beyond those from the US study …”

Section: Discussionmentioning

confidence: 75%

“…A smaller study using US data (n = 5444) that compared healthcare costs related to initiation of either dapagliflozin or sitagliptin reported similar findings, despite using a different methodology and using data from a country with a different healthcare infrastructure (eg, more than three-fold healthcare costs and insurance-based healthcare than in the present study). 38 They also concluded that the lower hospital healthcare cost associated with dapagliflozin treatment was offset by the higher drug costs. 38 The present study evaluated a larger, well-matched population (based on 96 clinical and cost variables at baseline, using propensity score matching) with a longer duration of follow-up, thus providing important additional detailsed insights beyond those from the US study.…”

Section: Discussionmentioning

confidence: 99%

“…38 They also concluded that the lower hospital healthcare cost associated with dapagliflozin treatment was offset by the higher drug costs. 38 The present study evaluated a larger, well-matched population (based on 96 clinical and cost variables at baseline, using propensity score matching) with a longer duration of follow-up, thus providing important additional detailsed insights beyond those from the US study. 38 The present study is based on the cumulative healthcare costs reported to authorities by healthcare providers for reimbursement purposes, that is, DRG costs for hospital visits and the historic costs of drugs dispensed by the pharmacy.…”

Section: Discussionmentioning

confidence: 99%

“…38 The present study evaluated a larger, well-matched population (based on 96 clinical and cost variables at baseline, using propensity score matching) with a longer duration of follow-up, thus providing important additional detailsed insights beyond those from the US study. 38 The present study is based on the cumulative healthcare costs reported to authorities by healthcare providers for reimbursement purposes, that is, DRG costs for hospital visits and the historic costs of drugs dispensed by the pharmacy. 39 This analysis was based on historic data and on the cost of drugs and procedures, and no updated costs to reflect modern pricing have been used.…”

Section: Discussionmentioning

confidence: 99%

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Dapagliflozin vs non‐SGLT‐2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE‐TIMI 58 trial: A nationwide observational study

Norhammar

Bodegård

Nyström

et al. 2019

Diabetes Obesity Metabolism

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Aims To investigate how the cardiovascular (CV) risk benefits of dapagliflozin translate into healthcare costs compared with other non‐sodium–glucose cotransporter‐2 inhibitor glucose‐lowering drugs (oGLDs) in a real‐world population with type 2 diabetes (T2D) that is similar to the population of the DECLARE‐TIMI 58 trial. Methods Patients initiating dapagliflozin or oGLDs between 2013 and 2016 in Swedish nationwide healthcare registries were included if they fulfilled inclusion and exclusion criteria of the DECLARE‐TIMI 58 trial (DECLARE‐like population). Propensity scores for the likelihood of dapagliflozin initiation were calculated, followed by 1:3 matching with initiators of oGLDs. Per‐patient cumulative costs for hospital healthcare (in‐ and outpatient) and for drugs were calculated from new initiation until end of follow‐up. Results A total of 24 828 patients initiated a new GLD; 6207 initiated dapagliflozin and 18 621 initiated an oGLD. After matching based on 96 clinical and healthcare cost variables, groups were balanced at baseline. Mean cumulative 30‐month healthcare cost per patient was similar in the dapagliflozin and oGLD groups ($11 807 and $11 906, respectively; difference, −$99; 95% CI, −$629, $483; P = 0.644). Initiation of dapagliflozin rather than an oGLD was associated with significantly lower hospital costs (−$658; 95% CI, −$1169, −$108; P = 0.024) and significantly higher drug costs ($559; 95% CI, $471, $648; P < 0.001). Hospital cost difference was related mainly to fewer CV‐ and T2D‐associated complications with use of dapagliflozin compared with use of an oGLD (−$363; 95% CI, −$665, −$61; P = 0.008). Conclusion In a nationwide, real‐world, DECLARE‐like population, dapagliflozin was associated with lower hospital costs compared with an oGLD, mainly as a result of reduced rates of CV‐ and T2D‐associated complications.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Dapagliflozin vs non‐SGLT‐2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE‐TIMI 58 trial: A nationwide observational study

Norhammar

Bodegård

Nyström

et al. 2019

Diabetes Obesity Metabolism

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Implementation of Empagliflozin in Patients with Diabetes Mellitus Type 2 and Established Cardiovascular Disease: Estimation of 5-Year Survival and Costs in Sweden

et al. 2020

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Introduction: Cardiovascular disease (CVD) affects approximately 30% of patients with diabetes mellitus type 2 (T2D) and leads to increased morbidity, decreased survival and increased healthcare utilization. The aim of this study was to estimate the impact of treating these patients with the sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin on survival and healthcare utilization. Methods: Actual survival and healthcare utilization data from a 5-year retrospective cohort

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Budget Impact of Oral Semaglutide Intensification versus Sitagliptin among US Patients with Type 2 Diabetes Mellitus Uncontrolled with Metformin

et al. 2020

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Background Oral semaglutide was approved in 2019 for blood glucose control in patients with type 2 diabetes mellitus (T2DM) and was the first oral glucagon-like peptide 1 receptor agonist (GLP-1 RA). T2DM is associated with substantial healthcare expenditures in the US, so the cost of a new intervention should be weighed against clinical benefits. Objective This study evaluated the budget impact of a treatment pathway with oral semaglutide 14 mg daily versus oral sitagliptin 100 mg daily among patients not achieving target glycated hemoglobin (HbA1c) level despite treatment with metformin. Methods This study used the validated IQVIA™ CORE Diabetes Model to simulate the treatment impact of oral semaglutide 14 mg and sitagliptin 100 mg over a 5-year time horizon from a US healthcare sector (payer) perspective. Trial data (PIONEER 3) informed cohort characteristics and treatment effects, and literature sources informed event costs. Population and market share data were from the literature and data on file. The analysis evaluated the estimated budget impact of oral semaglutide 14 mg use for patients currently using sitagliptin 100 mg considering both direct medical and treatment costs to understand the impact on total cost of care, given underlying treatment performance and impact on avoidable events. Results In a hypothetical plan of 1 million lives, an estimated 1993 patients were treated with sitagliptin 100 mg in the target population. Following these patients over 5 years, the incremental direct medical and treatment costs of a patient using oral semaglutide 14 mg versus sitagliptin 100 mg was $US16,562, a 70.7% increase (year 2019 values). A hypothetical payer would spend an additional $US3,300,143 (7.1%) over 5 years for every 10% of market share that oral semaglutide 14 mg takes away from sitagliptin 100 mg. Univariate and scenario analyses with alternate inputs and assumptions demonstrated consistent results. Conclusions Use of oral semaglutide 14 mg in patients currently receiving sitagliptin 100 mg substantially increases the budget impact for patients with T2DM whose blood glucose level is not controlled with metformin over a 5-year time horizon for US healthcare payers. Plain Language Summary Patients with type 2 diabetes mellitus (T2DM) have many treatment options. Choices depend on factors such as cost, preference, and patient characteristics. Oral semaglutide was recently approved for the treatment of T2DM as the first oral therapy Digital Features To view digital features for this article go to

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Comparison of healthcare resource utilization and costs in patients with type 2 diabetes initiating dapagliflozin versus sitagliptin

Cited by 7 publications

References 26 publications

Dapagliflozin vs non‐SGLT‐2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE‐TIMI 58 trial: A nationwide observational study

Dapagliflozin vs non‐SGLT‐2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE‐TIMI 58 trial: A nationwide observational study

Implementation of Empagliflozin in Patients with Diabetes Mellitus Type 2 and Established Cardiovascular Disease: Estimation of 5-Year Survival and Costs in Sweden

Budget Impact of Oral Semaglutide Intensification versus Sitagliptin among US Patients with Type 2 Diabetes Mellitus Uncontrolled with Metformin

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