Insulin degludec/liraglutide versus its monotherapy on T2D patients: A lifetime cost-utility analysis in China

Han, Guilin; Hu, Shanshan; Zhang, Xiaoning; Qiu, Zhi-Kun; Huang, Ze

doi:10.3389/fphar.2022.1011624

Cited by 3 publications

(4 citation statements)

References 44 publications

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“…IDegLira was first listed in Switzerland in 2015. 27 In 2017, the -9 of 12 (48 mmol/mol) was significantly higher than that of insulin or GLP-1RA, respectively. The above results showed that IDegLira had better advantages in blood glucose control and is recommended for reducing blood sugar in T2DM in terms of efficacy.…”

Section: Discussionmentioning

confidence: 93%

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Efficacy and safety of fixed‐ratio combination insulin degludec/liraglutide in type 2 diabetes: A systematic review and meta‐analysis of randomised controlled trials

Wang,

Luo,

Xiao

et al. 2023

Diabetes Metabolism Res

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BackgroundThe efficacy and safety of fixed‐ratio combination insulin degludec/liraglutide (IDegLira) for type 2 diabetes (T2DM) were extensively investigated by the global DUAL trials. However, the evidence on its efficacy and safety in T2DM has not been systematically reviewed.MethodsRandomized controlled trials published in English that compared IDegLira with placebo or GLP‐1 agonists or insulin in patients with T2DM were selected up to December 2022. Data on the study characteristics, efficacy and safety outcomes were extracted. We compared the efficacy and safety between “IDegLira versus Insulin,” “IDegLira versus GLP‐1RA,” and “IDegLira versus Placebo”. The risk of potential bias was assessed.ResultsIn terms of glycaemic efficacy, IDegLira reduced levels of glycated haemoglobin (HbA1c; weighted mean differences (WMDs) 0.52%, 95% CI 0.33%–0.71%); fasting blood glucose (0.32 mg/dL, 0.14–0.50 mg/dL), and the nine‐point self‐measured plasma glucose (0.25 mmol/L, 0.25–0.36 mmol/L). Furthermore, IDegLira was generally better in the attainment of HbA1c < 7.0% or ≤6.5%, HbA1c < 7.0% or ≤6.5% without weight gain and/or without severe or blood glucose‐confirmed hypoglycaemic episodes. In non‐glycaemic efficacy aspects, IDegLira decreased systolic blood pressure but elevated heart rate. In terms of safety outcomes, IDegLira did not appear to be associated with a risk of hypoglycaemia (RR 1.23, 0.85–1.78) and nocturnal hypoglycaemia (0.89, 0.52–1.52) occurring when compared with other hypoglycaemic agents or placebo.ConclusionsIDegLira improves better glycaemic and non‐glycaemic outcomes without weight gain and/or without severe or blood glucose‐confirmed hypoglycaemic episodes in T2DM. Side effects of IDegLira are mild.

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Section: Discussionmentioning

confidence: 93%

“…IDegLira was first listed in Switzerland in 2015 27 . In 2017, the Food and Drug Administration (FDA) approved IDegLira to be listed in the United States.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of fixed‐ratio combination insulin degludec/liraglutide in type 2 diabetes: A systematic review and meta‐analysis of randomised controlled trials

Wang,

Luo,

Xiao

et al. 2023

Diabetes Metabolism Res

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“…A combination therapy of IDegLira did not demonstrate 'financial superiority' over its monotherapy components (IDeg and Lira) in the treatment of T2D in a CUA conducted in China [34]. No gains were observed in QALYs (11.79, 11.62, and 11.73, respectively), medications costs (USD 20,281.61, USD 3726.76 and USD 11,941.26, respectively), complication costs (USD 25,274.22, USD 25,016.67 and USD 25,204.84, respectively), total costs (USD 45,555.83, USD 28,743.43 and USD 36,660.18, respectively), incremental cost-utility ratio values (USD 99,464.12/QALYs and USD 143,348.26/QALYs, respectively; both surpassed the WTP threshold) nor net monetary benefits (−10,447.67 and −6200.68, respectively).…”

Section: Cua Studiesmentioning

confidence: 83%

“…The latter of these is significant, as all of the studies reporting IDeg and similar insulin mixes to be more effective than insulin glargine variants considered hypoglycemic events, which were key in determining IDeg variants to be more cost-effective. Additionally, a CUA in China found treatment with combination therapy iDegLira to be significantly less cost-effective than either degludec or liraglutide monotherapy despite achieving the highest QALY, due to its high cost in the Chinese market [34].…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Economic Evaluations of Insulin for the Management of Type 2 Diabetes

Gkrinia,

Faour,

Belančić

et al. 2023

Diabetology

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Diabetes is a chronic, metabolic disease characterized by hyperglycemia, which occurs as a result of inadequate production or utilization of insulin. Type 2 diabetes (T2D) is the most common type of diabetes with estimates projecting a prevalence of more than 1 billion people living with T2DM by 2050. Hence, it was decided to conduct a systematic literature review of health economic evaluations of insulin, the most common medication used for the treatment of the disease, to inform policy. Pharmacoeconomic analyses, written in English and published after 2016, were considered for inclusion. PubMed/Medline, Global Health, Embase and Health Management Consortium were searched separately between 5 July 2023 and 17 July 2023. Grey literature articles were searched on ISPOR and the Cost-Effectiveness Analysis Registry during the same period. After the exclusion criteria were applied, 21 studies were included. Using the BMJ checklist, a quality appraisal was performed on all included studies. Data extraction was performed manually. Regarding evidence synthesis, data were heterogenous and are presented based on study type. The results showed a variety of treatment combinations being available for the treatment of diabetes, with insulin degludec/DegLira and semaglutide being cost-effective despite their high cost, due to the effectiveness of managing the disease. Research around the cost-effectiveness or cost-utility of insulin has potential to progress further, to ensure informed policy-making in the future.

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Adverse drug events in cost-effectiveness models of pharmacological interventions for diabetes, diabetic retinopathy, and diabetic macular edema: a scoping review

Pesonen,

Jylhä,

Kankaanpää

2024

JBI Evidence Synthesis

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Objective: The objective of this review was to examine the role of adverse drug events (ADEs) caused by pharmacological interventions in cost-effectiveness models for diabetes mellitus, diabetic retinopathy, and diabetic macular edema. Introduction: Guidelines for economic evaluation recognize the importance of including ADEs in the analysis, but in practice, consideration of ADEs in cost-effectiveness models seem to be vague. Inadequate inclusion of these harmful outcomes affects the reliability of the results, and the information provided by economic evaluation could be misleading. Reviewing whether and how ADEs are incorporated in cost-effectiveness models is necessary to understand the current practices of economic evaluation. Inclusion criteria: Studies included were published between 2011–2022 in English, representing cost-effectiveness analyses using modeling framework for pharmacological interventions in the treatment of diabetes mellitus, diabetic retinopathy, or diabetic macular edema. Other types of analyses and other types of conditions were excluded. Methods: The databases searched included MEDLINE (PubMed), CINAHL (EBSCOhost), Scopus, Web of Science Core Collection, and NHS Economic Evaluation Database. Gray literature was searched via the National Institute for Health and Care Excellence, European Network for Health Technology Assessment, the National Institute for Health and Care Research, and the International Network of Agencies for Health Technology Assessment. The search was conducted on January 1, 2023. Titles and abstracts were screened for inclusion by 2 independent reviewers. Full-text review was conducted by 3 independent reviewers. A data extraction form was used to extract and analyze the data. Results were presented in tabular format with a narrative summary, and discussed in the context of existing literature and guidelines. Results: A total of 242 reports were extracted and analyzed in this scoping review. For the included analyses, type 2 diabetes was the most common disease (86%) followed by type 1 diabetes (10%), diabetic macular edema (9%), and diabetic retinopathy (0.4%). The majority of the included analyses used a health care payer perspective (88%) and had a time horizon of 30 years or more (75%). The most common model type was a simulation model (57%), followed by a Markov simulation model (18%). Of the included cost-effectiveness analyses, 26% included ADEs in the modeling, and 13% of the analyses excluded them. Most of the analyses (61%) partly considered ADEs; that is, only 1 or 2 ADEs were included. No difference in overall inclusion of ADEs between the different conditions existed, but the models for diabetic retinopathy and diabetic macular edema more often omitted the ADE-related impact on quality of life compared with the models for diabetes mellitus. Most analyses included ADEs in the models as probabilities (55%) or as a submodel (40%), and the most common source for ADE incidences were clinical trials (65%). Conclusions: The inclusion of ADEs in cost-effectiveness models is suboptimal. The ADE-related costs were better captured than the ADE-related impact on quality of life, which was most pronounced in the models for diabetic retinopathy and diabetic macular edema. Future research should investigate the potential impact of ADEs on the results, and identify the criteria and policies for practical inclusion of ADEs in economic evaluation.

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Insulin degludec/liraglutide versus its monotherapy on T2D patients: A lifetime cost-utility analysis in China

Cited by 3 publications

References 44 publications

Efficacy and safety of fixed‐ratio combination insulin degludec/liraglutide in type 2 diabetes: A systematic review and meta‐analysis of randomised controlled trials

Efficacy and safety of fixed‐ratio combination insulin degludec/liraglutide in type 2 diabetes: A systematic review and meta‐analysis of randomised controlled trials

A Systematic Review of Economic Evaluations of Insulin for the Management of Type 2 Diabetes

Adverse drug events in cost-effectiveness models of pharmacological interventions for diabetes, diabetic retinopathy, and diabetic macular edema: a scoping review

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