Evaluating the Cost-Effectiveness of GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes in the UK

Ashley, Donna; Vega, G; Hunt, Barnaby; Valentine, WJ

doi:10.1016/j.jval.2015.09.2093

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“…Often, new drugs are evaluated against very similar agents or against placebo. Liraglutide was previously compared with other GLP-1RA products in the UK [ 4 , 5 , 28 ] and was recommended by the Scottish Medicines Consortium on the basis of acceptable cost-effectiveness compared to other GLP-1RAs [ 29 , 30 ]. Treatment decisions, however, need to weigh the merits and risks of different drug classes for a patient, but UK studies comparing liraglutide against drugs from other classes are infrequent.…”

Section: Discussionmentioning

confidence: 99%

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Cost-Effectiveness of Liraglutide Versus Dapagliflozin for the Treatment of Patients with Type 2 Diabetes Mellitus in the UK

2017

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IntroductionTo date there is a lack of economic analysis comparing glucagon-like peptide-1 receptor agonists (GLP-1RAs) to sodium-glucose co-transporter 2 inhibitors (SGLT-2i) for the treatment of type 2 diabetes mellitus (T2DM). Liraglutide and dapagliflozin are the most commonly prescribed GLP-1RA and SGLT-2i in the UK. This analysis investigated the cost-effectiveness of liraglutide 1.2 and 1.8 mg/day compared to dapagliflozin 10 mg/day for the treatment of T2DM in the UK in patients on dual and triple antidiabetic therapy.MethodsCost-effectiveness analysis was conducted in the QuintilesIMS CORE Diabetes Model (CDM). The model estimated expected costs and outcomes over a lifetime horizon using the UK national payer perspective. Liraglutide efficacy estimates and patient characteristics were sourced from a trial in patients on prior metformin monotherapy, and from a trial in patients on prior combination therapy. Comparative efficacy data for the other interventions were derived from a network meta-analysis. Utility inputs were extracted from a systematic literature review. Costs are presented in Great British Pound (GBP), 2016 values.ResultsIn dual and triple therapy, liraglutide 1.2 mg was less costly and more effective compared with dapagliflozin 10 mg, providing a QALY gain of 0.04 and cost savings of GBP 11 per patient in dual therapy, and a QALY gain of 0.06 and cost savings of GBP 71 per patient in triple therapy. For liraglutide 1.8 mg, increased efficacy and costs compared with dapagliflozin 10 mg were observed in both dual and triple therapy. In dual therapy, a QALY gain of 0.07 and additional costs of GBP 888 per patient yielded an ICER of GBP 13,227, whereas in triple therapy a QALY gain of 0.07 and additional cost of GBP 791 per patient gave an ICER of 11,857.ConclusionThis long-term modelling analysis found that both dosages of liraglutide may be cost-effective treatment alternatives as part of a dual or a triple antidiabetic therapy in patients for whom an SGLT-2i therapy is considered.FundingNovo Nordisk.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0250-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…Currently, there is evidence assessing the cost-effectiveness of the GLP1-RA liraglutide versus other GLP-1RAs [ 4 , 5 ]. However, there is a lack of health economic analyses comparing liraglutide to SGLT-2is.…”

Section: Introductionmentioning

confidence: 99%