Abstract:In Mexico, both doses of canagliflozin are likely to be cost-effective versus sitagliptin in patients with T2DM who have inadequate glucose control on metformin, primarily because of better biomarker control and higher QALYs.
“…1 ). The model has been validated for established effects of AHAs on parameters including glucose, body weight, BP, and renal function [ 19 , 34 , 35 ], and its application to cost-effectiveness evaluations of canagliflozin has been reported in detail elsewhere [ 21 , 23 ]. Fig.…”
Section: Methodsmentioning
confidence: 99%
“…Owing to the impracticality of obtaining evidence over a sufficient duration to capture the full impact of interventions over time, economic modeling is widely used as a method to generate such evidence, thus enabling assessment of the impact of alternative interventions [ 19 , 20 ]. Economic simulations have been used to evaluate the cost-effectiveness of canagliflozin and dapagliflozin versus other AHA classes [ 21 – 28 ]. For example, canagliflozin 100 and 300 mg have demonstrated cost-effectiveness in second- and third-line therapy versus the DPP-4 inhibitor sitagliptin 100 mg in Mexico [ 21 ] and Canada [ 23 ].…”
Section: Introductionmentioning
confidence: 99%
“…Economic simulations have been used to evaluate the cost-effectiveness of canagliflozin and dapagliflozin versus other AHA classes [ 21 – 28 ]. For example, canagliflozin 100 and 300 mg have demonstrated cost-effectiveness in second- and third-line therapy versus the DPP-4 inhibitor sitagliptin 100 mg in Mexico [ 21 ] and Canada [ 23 ]. Dapagliflozin has also been found to be cost-effective as monotherapy and in second-line therapy versus sulfonylurea, DPP-4 inhibitors, and acarbose in Nordic countries (i.e., Denmark, Finland, Norway, and Sweden) [ 22 ], the United Kingdom [ 24 , 25 ], Greece [ 26 ], and China [ 27 , 28 ].…”
IntroductionAgents that inhibit sodium glucose co-transporter 2 (SGLT2), including canagliflozin and dapagliflozin, are approved in the United States for the treatment of adults with type 2 diabetes mellitus (T2DM). SGLT2 inhibition lowers blood glucose by increasing urinary glucose excretion, which leads to a mild osmotic diuresis and a net loss of calories that are associated with reductions in body weight and blood pressure. This analysis evaluated the cost-effectiveness of canagliflozin 300 mg versus dapagliflozin 10 mg in patients with T2DM inadequately controlled with metformin in the United States.MethodsA 30-year cost-effectiveness analysis was performed using the validated Economic and Health Outcomes Model of T2DM (ECHO-T2DM) from the perspective of the third-party health care system in the United States. Patient demographics, biomarker values, and treatment effects for the ECHO-T2DM model were sourced primarily from a network meta-analysis (NMA) that included studies of canagliflozin and dapagliflozin in patients with T2DM on background metformin. Costs were derived from sources specific to the United States. Outcomes and costs were discounted at 3%. Sensitivity analyses that varied key model parameters were conducted.ResultsCanagliflozin 300 mg dominated dapagliflozin 10 mg as an add-on to metformin over 30 years, with an estimated cost offset of $13,991 and a quality-adjusted life-year gain of 0.08 versus dapagliflozin 10 mg. Results were driven by the better HbA1c lowering achieved with canagliflozin, which translated to less need for insulin rescue therapy. Findings from sensitivity analyses were consistent with the base case.ConclusionThese results suggest that canagliflozin 300 mg is likely to provide better health outcomes at a lower overall cost than dapagliflozin 10 mg in patients with T2DM inadequately controlled with metformin from the perspective of the United States health care system.FundingJanssen Scientific Affairs, LLC and Janssen Global Services, LLC.Electronic supplementary materialThe online version of this article (10.1007/s13300-018-0371-y) contains supplementary material, which is available to authorized users.
“…1 ). The model has been validated for established effects of AHAs on parameters including glucose, body weight, BP, and renal function [ 19 , 34 , 35 ], and its application to cost-effectiveness evaluations of canagliflozin has been reported in detail elsewhere [ 21 , 23 ]. Fig.…”
Section: Methodsmentioning
confidence: 99%
“…Owing to the impracticality of obtaining evidence over a sufficient duration to capture the full impact of interventions over time, economic modeling is widely used as a method to generate such evidence, thus enabling assessment of the impact of alternative interventions [ 19 , 20 ]. Economic simulations have been used to evaluate the cost-effectiveness of canagliflozin and dapagliflozin versus other AHA classes [ 21 – 28 ]. For example, canagliflozin 100 and 300 mg have demonstrated cost-effectiveness in second- and third-line therapy versus the DPP-4 inhibitor sitagliptin 100 mg in Mexico [ 21 ] and Canada [ 23 ].…”
Section: Introductionmentioning
confidence: 99%
“…Economic simulations have been used to evaluate the cost-effectiveness of canagliflozin and dapagliflozin versus other AHA classes [ 21 – 28 ]. For example, canagliflozin 100 and 300 mg have demonstrated cost-effectiveness in second- and third-line therapy versus the DPP-4 inhibitor sitagliptin 100 mg in Mexico [ 21 ] and Canada [ 23 ]. Dapagliflozin has also been found to be cost-effective as monotherapy and in second-line therapy versus sulfonylurea, DPP-4 inhibitors, and acarbose in Nordic countries (i.e., Denmark, Finland, Norway, and Sweden) [ 22 ], the United Kingdom [ 24 , 25 ], Greece [ 26 ], and China [ 27 , 28 ].…”
IntroductionAgents that inhibit sodium glucose co-transporter 2 (SGLT2), including canagliflozin and dapagliflozin, are approved in the United States for the treatment of adults with type 2 diabetes mellitus (T2DM). SGLT2 inhibition lowers blood glucose by increasing urinary glucose excretion, which leads to a mild osmotic diuresis and a net loss of calories that are associated with reductions in body weight and blood pressure. This analysis evaluated the cost-effectiveness of canagliflozin 300 mg versus dapagliflozin 10 mg in patients with T2DM inadequately controlled with metformin in the United States.MethodsA 30-year cost-effectiveness analysis was performed using the validated Economic and Health Outcomes Model of T2DM (ECHO-T2DM) from the perspective of the third-party health care system in the United States. Patient demographics, biomarker values, and treatment effects for the ECHO-T2DM model were sourced primarily from a network meta-analysis (NMA) that included studies of canagliflozin and dapagliflozin in patients with T2DM on background metformin. Costs were derived from sources specific to the United States. Outcomes and costs were discounted at 3%. Sensitivity analyses that varied key model parameters were conducted.ResultsCanagliflozin 300 mg dominated dapagliflozin 10 mg as an add-on to metformin over 30 years, with an estimated cost offset of $13,991 and a quality-adjusted life-year gain of 0.08 versus dapagliflozin 10 mg. Results were driven by the better HbA1c lowering achieved with canagliflozin, which translated to less need for insulin rescue therapy. Findings from sensitivity analyses were consistent with the base case.ConclusionThese results suggest that canagliflozin 300 mg is likely to provide better health outcomes at a lower overall cost than dapagliflozin 10 mg in patients with T2DM inadequately controlled with metformin from the perspective of the United States health care system.FundingJanssen Scientific Affairs, LLC and Janssen Global Services, LLC.Electronic supplementary materialThe online version of this article (10.1007/s13300-018-0371-y) contains supplementary material, which is available to authorized users.
“…62 Canagliflozin was found to be cost-effective compared with sitagliptin in patients with poorly controlled type 2 diabetes in a Mexican study. 63 In a US analysis of liraglutide compared with sitagliptin, the incremental cost-effectiveness ratio was between $25,742 and $37,234 per quality-adjusted life year gained, based on liraglutide dose. 64 In all sensitivity analyses, the incremental cost-effectiveness ratios remained below the commonly accepted threshold of $50,000 per quality-adjusted life year.…”
Section: Implications For Clinical Practicementioning
This review article summarizes the recent cardiovascular outcome data for sodium–glucose cotransporter-2 inhibitors and glucagon-like peptide-1 analogues, which have been found to reduce cardiovascular events. We also detail the implications these new medications will have on clinical practice through a review of recent diabetes guidelines and cost-effectiveness data.
“…However, in specific payer settings, canagliflozin 300 mg has shown to be cost-effective versus liraglutide (1.2 and 1.8 mg) and sitagliptin (100 mg). [121122123]…”
Section: Cost-effectiveness Of Canagliflozin 300 Mgmentioning
Currently available antihyperglycemic agents, despite being effective, provide inadequate glycemic control and/or are associated with side effects or nonadherence. Canagliflozin, a widely used orally active inhibitor of sodium-glucose cotransporter 2 (SGLT2), is a new addition to the therapeutic armamentarium of glucose-lowering drugs. This review summarizes findings from different clinical and observational studies of canagliflozin 300 mg in patients with type 2 diabetes mellitus (T2DM). By inhibiting SGLT2, canagliflozin reduces reabsorption of filtered glucose, thereby increasing urinary glucose excretion in patients with T2DM. Canagliflozin 300 mg has been shown to be effective in lowering glycated hemoglobin, fasting plasma glucose, and postprandial glucose in patients with T2DM. Canagliflozin 300 mg also demonstrated significant reductions in body weight and blood pressure and has a low risk of causing hypoglycemia, when not used in conjunction with insulin and insulin secretagogues. Canagliflozin 300 mg was generally well tolerated in clinical studies. The most frequently reported adverse events include genital mycotic infections, urinary tract infections, osmotic diuresis, and volume depletion-related events.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
