Health economic evaluation of canagliflozin in the treatment of type 2 diabetes mellitus in Belgium

Lamotte, M; Wyffels, Veronique; Knudsen, M.S.; Troelsgaard, A.; Hemels, M.

doi:10.1016/j.jval.2014.03.1446

Cited by 2 publications

(3 citation statements)

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“…This was also the case for canagliflozin 100 mg, based on economic evaluations in Spain56 and Poland,57 whereas canagliflozin 300 mg produced an ICER of €181356 and 45,008 zł57 compared with sitagliptin, respectively. Results from additional country-specific analyses versus sitagliptin also suggest that canagliflozin is likely to be a cost-effective option adjunct to metformin, in Ireland,58 France,59 Belgium,60 Slovakia,61 and the Czech Republic 62. Moreover, a NICE HTA for canagliflozin concluded that, due to small differences in costs and QALYs between canagliflozin and DPP-4 inhibitors, both canagliflozin 100 and 300 mg were recommended treatment options in patients inadequately controlled with metformin alone 63…”

Section: Methodsmentioning

confidence: 99%

“…Evidence from economic evaluations across different health care systems, including Sweden, Norway, Poland, Belgium, Ireland, and the Czech Republic, suggest that canagliflozin as add-on to metformin is cost-effective, compared with sulfonylureas 53,54,57,60,62,64. In a similar manner, dapagliflozin 10 mg was also dominated by canagliflozin in two economic evaluations in the USA and Spain, utilizing the Economic and Health Outcomes Model for type 2 diabetes mellitus (ECHO-T2DM)65 and the IMS Core Diabetes Model66, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…In particular, from the Canadian health care perspective, canagliflozin 100 and 300 mg provided QALY gains of 0.28 and 0.31, and cost savings of C$2560 and C$2217, respectively, over a time horizon of 40 years. 68 Canagliflozin also dominated sitagliptin across different countries, including Belgium, 60 France, 59 Norway, 54 and Portugal, 55 when both dosing schemes were assessed as a single intervention. Of note, additional economic evaluations concluded that canagliflozin was a cost-effective therapeutic option as add-on to metformin and sulfonylurea in Brazil, 69 Ireland, 58 Slovakia, 61 and the Czech Republic, 62 although it was associated with higher treatment costs compared with sitagliptin.…”

Section: Methodsmentioning

confidence: 99%

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Canagliflozin in the treatment of type 2 diabetes: an evidence-based review of its place in therapy

Karagiannis

Bekiari

2017

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IntroductionDeciding on an optimal medication choice for type 2 diabetes is often challenging, due to the increasing number of treatment options. Canagliflozin is a novel glucose-lowering agent belonging to sodium–glucose co-transporter 2 (SGLT2) inhibitors.AimThe aim of this study was to examine and summarize the evidence based on the efficacy, safety, and cost-effectiveness of canagliflozin for type 2 diabetes.Evidence reviewCompared to placebo, canagliflozin 100 and 300 mg lower glycated hemoglobin (HbA1c) by ~0.6%–0.8%, respectively. Canagliflozin appears to be slightly more effective than dipeptidyl peptidase-4 (DPP-4) inhibitors in reducing HbA1c. It also has a favorable effect on body weight and blood pressure, both versus placebo and most active comparators. However, treatment with canagliflozin is associated with increased incidence of genital tract infections and osmotic diuresis-related adverse events. Based on short-term data, canagliflozin is not associated with increased risk for all-cause mortality and cardiovascular outcomes. Economic evaluation studies from various countries indicate that canagliflozin is a cost-effective option in dual- or triple-agent regimens.Place in therapyAs monotherapy, canagliflozin could be used in patients for whom metformin is contraindicated or not tolerated. For patients on background treatment with metformin, canagliflozin appears to be superior to sulfonylureas with respect to body weight, blood pressure and risk for hypoglycemia, and to DPP-4 inhibitors in terms of lowering HbA1c, body weight, and blood pressure. Canagliflozin also seems to be cost-effective compared with sulfonylureas and DPP-4 inhibitors as add-on to metformin monotherapy, and compared with DPP-4 inhibitors as add-on to metformin and sulfonylurea.ConclusionCurrent evidence on intermediate efficacy outcomes, short-term safety and cost-effectiveness support the use of canagliflozin in patients on background treatment with metformin. Robust long-term data regarding the effect of canagliflozin on cardiovascular endpoints will be available upon completion of the Canagliflozin Cardiovascular Assessment Study (CANVAS) trial.

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