Long-term Cost-effectiveness of Two GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus in the Italian Setting: Liraglutide Versus Lixisenatide

Hunt, Barnaby; Kragh, Nana; McConnachie, Ceilidh C.; Valentine, William J.; Rossi, Maria Chiara; Montagnoli, Roberta

doi:10.1016/j.clinthera.2017.05.354

Cited by 20 publications

(20 citation statements)

References 29 publications

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“…A simple treatment algorithm which assumed that patients received once-weekly semaglutide or dulaglutide for 3 years was employed, as per previous long-term cost-effectiveness analyses of GLP-1 receptor agonists submitted to NICE and published in peer-reviewed journals. [32][33][34][35] This is also supported by data from general practice in the European Union big five markets, which reported a mean duration of treatment with GLP-1 receptor agonists of 29.35 months, rounded to 3 years, as treatment switching can occur only at the end of an annual cycle in the CDM. 36 After 3 years, treatment with once-weekly semaglutide or dulaglutide was discontinued and patients were assumed to intensify to basal insulin therapy with the most commonly used basal insulin analogue available in the UK, insulin glargine, with the cost of the least expensive, biosimilar version of insulin glargine applied (Abasaglar).…”

Section: Treatment Switching and Long-term Parameter Progressionmentioning

confidence: 58%

“…A simple treatment algorithm which assumed that patients received once‐weekly semaglutide or dulaglutide for 3 years was employed, as per previous long‐term cost‐effectiveness analyses of GLP‐1 receptor agonists submitted to NICE and published in peer‐reviewed journals . This is also supported by data from general practice in the European Union big five markets, which reported a mean duration of treatment with GLP‐1 receptor agonists of 29.35 months, rounded to 3 years, as treatment switching can occur only at the end of an annual cycle in the CDM .…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of the long‐term cost‐effectiveness of once‐weekly semaglutide versus dulaglutide for treatment of type 2 diabetes mellitus in the UK

Viljoen

Hoxer

Johansen

et al. 2018

Diabetes Obesity Metabolism

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Aims Glucagon‐like peptide‐1 (GLP‐1) receptor agonists are appealing as glucose‐lowering therapy for individuals with type 2 diabetes mellitus (T2DM) as they also reduce body weight and are associated with low rates of hypoglycaemia. This analysis assessed the long‐term cost‐effectiveness of semaglutide 0.5 and 1 mg vs dulaglutide 1.5 mg (two once‐weekly GLP‐1 receptor agonists) from a UK healthcare payer perspective, based on the head‐to‐head SUSTAIN 7 trial, to inform healthcare decision making. Materials and Methods Long‐term outcomes were projected using the IQVIA CORE Diabetes Model (version 9.0). Baseline cohort characteristics, changes in physiological parameters and adverse event rates were derived from the 40‐week SUSTAIN 7 trial. Costs to a healthcare payer were assessed, and these captured pharmacy costs and costs of complications. Utilities were taken from published sources. Results Once‐weekly semaglutide 0.5 and 1 mg were associated with improvements in quality‐adjusted life expectancy of 0.04 and 0.10 quality‐adjusted life years, respectively, compared with dulaglutide 1.5 mg. Clinical benefits were achieved at reduced costs, with lifetime cost savings of GBP 35 with once‐weekly semaglutide 0.5 mg and GBP 106 with the once‐weekly semaglutide 1 mg, resulting from fewer diabetes‐related complications due to better glycaemic control. Therefore, both doses of once‐weekly semaglutide were considered dominant vs dulaglutide 1.5 mg (improving outcomes and reducing costs). Conclusions Compared with treatment with dulaglutide, once‐weekly semaglutide represents a cost‐effective option for treating individuals in the UK with T2DM who are not achieving glycaemic control with metformin, projected to both improve clinical outcomes and reduce costs.

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Section: Treatment Switching and Long-term Parameter Progressionmentioning

confidence: 58%

Section: Methodsmentioning

confidence: 99%

Evaluation of the long‐term cost‐effectiveness of once‐weekly semaglutide versus dulaglutide for treatment of type 2 diabetes mellitus in the UK

Viljoen

Hoxer

Johansen

et al. 2018

Diabetes Obesity Metabolism

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“…13,24 There is no current uniform national or international consensus for the optimal treatment regimen in type 2 diabetes, including the intensification steps beyond monotherapy, the ideal combination when basal insulin is introduced, and the In contrast with long-term models of type 2 diabetes, rates of complications were not included, as they were not expected to vary over the short-term time horizon of the analysis. [44][45][46] Furthermore, glycaemic control, a key driver of rates of diabetes-related complications, was equivalent in both arms. However, rates of diabetes-related complications can also be influenced by blood pressure, BMI and serum lipid levels, and IDegLira was associated with improvements in all of these risk factors versus BBT in the DUAL VII trial.…”

Section: Discussionmentioning

confidence: 96%

“…In contrast with long‐term models of type 2 diabetes, rates of complications were not included, as they were not expected to vary over the short‐term time horizon of the analysis 44, 45, 46. Furthermore, glycaemic control, a key driver of rates of diabetes‐related complications, was equivalent in both arms.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is common practice to adapt clinical trial data from multinational cohorts to country‐specific analyses, with this methodology found throughout the published literature 45, 46, 50, 51, 52. Moreover, the effect of IDegLira and BBT would not be expected to vary across the different country settings included in the DUAL VII trial and the UK.…”

Section: Discussionmentioning

confidence: 99%

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The management of type 2 diabetes with fixed‐ratio combination insulin degludec/liraglutide (IDegLira) versus basal‐bolus therapy (insulin glargine U100 plus insulin aspart): A short‐term cost‐effectiveness analysis in the UK setting

Drummond

Malkin²,

Preez

et al. 2018

Diabetes Obesity Metabolism

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AimTo evaluate the cost‐effectiveness of IDegLira versus basal‐bolus therapy (BBT) with insulin glargine U100 plus up to 4 times daily insulin aspart for the management of type 2 diabetes in the UK.MethodsA Microsoft Excel model was used to evaluate the cost‐utility of IDegLira versus BBT over a 1‐year time horizon. Clinical input data were taken from the treat‐to‐target DUAL VII trial, conducted in patients unable to achieve adequate glycaemic control (HbA1c <7.0%) with basal insulin, with IDegLira associated with lower rates of hypoglycaemia and reduced body mass index (BMI) in comparison with BBT, with similar HbA1c reductions. Costs (expressed in GBP) and event‐related disutilities were taken from published sources. Extensive sensitivity analyses were performed.ResultsIDegLira was associated with an improvement of 0.05 quality‐adjusted life years (QALYs) versus BBT, due to reductions in non‐severe hypoglycaemic episodes and BMI with IDegLira. Costs were higher with IDegLira by GBP 303 per patient, leading to an incremental cost‐effectiveness ratio (ICER) of GBP 5924 per QALY gained for IDegLira versus BBT. ICERs remained below GBP 20 000 per QALY gained across a range of sensitivity analyses.ConclusionsIDegLira is a cost‐effective alternative to BBT with insulin glargine U100 plus insulin aspart, providing equivalent glycaemic control with a simpler treatment regimen for patients with type 2 diabetes inadequately controlled on basal insulin in the UK.

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Costs and where to find them: identifying unit costs for health economic evaluations of diabetes in France, Germany and Italy

Pöhlmann¹,

Norrbacka²,

Boye

et al. 2020

Eur J Health Econ

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Background Health economic evaluations require cost data as key inputs. Many countries do not have standardized reference costs so costs used often vary between studies, thereby reducing transparency and transferability. The present review provided a comprehensive overview of cost sources and suggested unit costs for France, Germany and Italy, to support health economic evaluations in these countries, particularly in the field of diabetes. Methods A literature review was conducted across multiple databases to identify published unit costs and cost data sources for resource items commonly used in health economic evaluations of antidiabetic therapies. The quality of unit cost reporting was assessed with regard to comprehensiveness of cost reporting and referencing as well as accessibility of cost sources from published cost-effectiveness analyses (CEA) of antidiabetic medications. Results An overview of cost sources, including tariff and fee schedules as well as published estimates, was developed for France, Germany and Italy, covering primary and specialist outpatient care, emergency care, hospital treatment, pharmacy costs and lost productivity. Based on these sources, unit cost datasets were suggested for each country. The assessment of unit cost reporting showed that only 60% and 40% of CEAs reported unit costs and referenced them for all pharmacy items, respectively. Less than 20% of CEAs obtained all pharmacy costs from publicly available sources. Conclusions This review provides a comprehensive account of available costs and cost sources in France, Germany and Italy to support health economists and increase transparency in health economic evaluations in diabetes.

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Long-term Cost-effectiveness of Two GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus in the Italian Setting: Liraglutide Versus Lixisenatide

Cited by 20 publications

References 29 publications

Evaluation of the long‐term cost‐effectiveness of once‐weekly semaglutide versus dulaglutide for treatment of type 2 diabetes mellitus in the UK

Evaluation of the long‐term cost‐effectiveness of once‐weekly semaglutide versus dulaglutide for treatment of type 2 diabetes mellitus in the UK

The management of type 2 diabetes with fixed‐ratio combination insulin degludec/liraglutide (IDegLira) versus basal‐bolus therapy (insulin glargine U100 plus insulin aspart): A short‐term cost‐effectiveness analysis in the UK setting

Costs and where to find them: identifying unit costs for health economic evaluations of diabetes in France, Germany and Italy

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