The cost-effectiveness of dulaglutide versus liraglutide for the treatment of type 2 diabetes mellitus in Spain in patients with BMI ≥30 kg/m<sup>2</sup>

Dilla, Tatiana; Alexiou, Dimitra; Chatzitheofilou, Ismini; Ayyub, Ruba; Lowin, Julia; Norrbacka, Kirsi

doi:10.1080/13696998.2016.1275651

Cited by 17 publications

(11 citation statements)

References 31 publications

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“…Although five GLP-1 RAs are registered in the Spanish market, information is limited on patient demographics, treatment practices, clinical outcomes, healthcare resource use and related costs among patients with T2DM initiating GLP-1 RA therapy in this country [19][20][21][22][23][24]. In Spain, GLP-1 RAs are usually prescribed in combination with OADs or OAD/insulin to relatively young patients with poor glycaemic control and high body mass index (BMI) [20].…”

Section: Introductionmentioning

confidence: 99%

Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain

Norrbacka¹,

Sicras‐Mainar

Lebrec³

et al. 2021

Diabetes Ther

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Introduction This study aimed to describe utilization patterns, persistence, resource utilization and costs in patients with type 2 diabetes mellitus initiating treatment with glucagon-like peptide 1 receptor agonists in routine clinical practice in Spain. Methods This retrospective study of medical records in the Big-Pac database identified adults starting treatment with once-weekly (QW) dulaglutide, exenatide-QW or once-daily liraglutide between 1 November 2015 and 30 June 2017. Patients were followed for up to 18 months from treatment initiation. Data on clinical characteristics of patients, treatment patterns, average daily dose and costs were obtained for the three cohorts. Persistence over the 18-month period was evaluated using Kaplan–Meier curves. All analyses were descriptive. Results A total of 1402 patients were included in this study (dulaglutide [ n = 492], exenatide-QW [ n = 438] or liraglutide [ n = 472]); 52.8% were men, and the mean (SD) age was 62 (11) years, glycated haemoglobin (HbA1c) was 8.1% (1.2) and body mass index was 35.5 (3.2) kg/m 2 at treatment initiation. Persistence at 18 months was 59.1% (95% confidence interval [CI] 54.8–63.4) for dulaglutide, 45.7% (95% CI 41.0–50.4) for exenatide-QW and 46.6% (95% CI 42.1–51.1) for liraglutide. The average (SD) dose was 1.2 (0.4) mg/week for dulaglutide, 1.9 (0.3) mg/week for exenatide-QW and 1.1 (0.3) mg/day for liraglutide. The average reduction in HbA1c levels at 1 year was − 0.68% for patients who initiated dulaglutide, − 0.54% for patients who initiated exenatide-QW and − 0.50% for patients who initiated liraglutide. The mean (SD) total annual health care costs were €4072 (1946) for dulaglutide, €4418 (2382) for exenatide-QW and €4382 (2389) for liraglutide. Conclusion Results suggest that patients who started treatment with dulaglutide had higher persistence over 18 months, presented lower HbA1c levels at 12 months and incurred lower annual total healthcare costs than patients who initiated exenatide-QW or liraglutide. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-021-01039-5.

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Section: Introductionmentioning

confidence: 99%

Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain

Norrbacka¹,

Sicras‐Mainar

Lebrec³

et al. 2021

Diabetes Ther

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“…The results were not conclusive for the aGLP-1. 20,21,23,25,33,35–66 Albiglutide appeared to be a more cost-effective option than sitagliptin, 35 but the results were the opposite when comparing the general subgroups to which these NIADs belonged (aGLP-1 versus iDPP-4). 20 Exenatide was a more cost-effective treatment than another analogue such as lixisenatide (ICER of €12,600/QALY), 36 but no conclusive results were obtained in comparison with other analogues such as liraglutide, 36–41 or dulaglutide.…”

Section: Resultsmentioning

confidence: 97%

“…55 Lixisenatide did not appear to be a more cost-effective option than other analogues such as exenatide 36 or liraglutide. 39,47–49 Dulaglutide was dominant over liraglutide, 46 but contradictory results were obtained versus exenatide. 36,42…”

Section: Resultsmentioning

confidence: 99%

“…55 Lixisenatide did not appear to be a more cost-effective option than other analogues such as exenatide 36 or liraglutide. 39,[47][48][49] Dulaglutide was dominant over liraglutide, 46 but contradictory results were obtained versus exenatide. 36,42 For the iDPP-4, no conclusive results were obtained, 20,21,24,[26][27][28]34,35,37,43,44,[50][51][52][53][54]56,[68][69][70][71][72][73][74][75][76][77] except when they were compared with the iSGLT-2.…”

Section: Quality Of the Studiesmentioning

confidence: 99%

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A systematic review of economic evaluations in non-insulin antidiabetic treatments for patients with type 2 diabetes mellitus

Zozaya

Capel

Simón

et al. 2019

Global & Regional Health Technology Assessment

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The approval of new non-insulin treatments has broadened the therapeutic arsenal, but it has also increased the complexity of choice for the treatment of type 2 diabetes mellitus (DM2). The objective of this study was to systematically review the literature on economic evaluations associated with non-insulin antidiabetic drugs (NIADs) for DM2. We searched in Medline, IBECS, Doyma and SciELO databases for full economic evaluations of NIADs in adults with DM2 applied after the failure of the first line of pharmacological treatment, published between 2010 and 2017, focusing on studies that incorporated quality-adjusted life years (QALYs). The review included a total of 57 studies, in which 134 comparisons were made between NIADs. Under an acceptability threshold of 25,000 euros per QALY gained, iSLGT-2 were preferable to iDPP-4 and sulfonylureas in terms of incremental cost-utility. By contrast, there were no conclusive comparative results for the other two new NIAD groups (GLP-1 and iDPP-4). The heterogeneity of the studies’ methodologies and results hindered our ability to determine under what specific clinical assumptions some NIADs would be more cost-effective than others. Economic evaluations of healthcare should be used as part of the decision-making process, so multifactorial therapeutic management strategies should be established based on the patients’ clinical characteristics and preferences as principal criteria.

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“…Several reports compared the real-world use of GLP-1 RAs, but most comparisons were restricted to treatment maintenance 25,26 and cost-effectiveness 27 . In contrast, our study examined changes in HbA1c levels.…”

Section: Discussionmentioning

confidence: 99%

Real-World Effectiveness of Liraglutide Versus Dulaglutide In Japanese Patients With Type 2 Diabetes: A Retrospective Study

Tanaka

Okada

Tokutsu

et al. 2021

Preprint

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Real-world data comparing the effectiveness of various glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in type 2 diabetes mellitus (T2DM) are limited. We investigated the clinical effectiveness of liraglutide and dulaglutide in Japanese T2DM in a real-world setting. This retrospective study included 179 patients with T2DM who were treated with GLP-1 RA for at least 12 months (liraglutide, n=97; dulaglutide, n=82). Changes in glycated hemoglobin (HbA1c) at the end of 12-month treatment were evaluated. Compared with the liraglutide group, the dulaglutide group included significantly older patients with longer disease duration, lower body mass index, and higher proportion of dementia cases. HbA1c was significantly lower at 12 months in both groups (liraglutide, 8.9 to 7.6%; dulaglutide, 8.8 to 7.5%). Hierarchical regression analysis showed no differences in the extent of changes in HbA1c at 12 months between the two agents, after adjustment for differences in patient characteristics and drug adjustments during the 12-month period. High baseline HbA1c, the addition of GLP-1 RA treatment, and in-hospital initiation of GLP-1 RA treatment were identified as significant contributing factors to HbA1c reduction. Although patient characteristics were different between the two treatment groups, comparable HbA1c-lowering effects were noted in real-world settings.

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The cost-effectiveness of dulaglutide versus liraglutide for the treatment of type 2 diabetes mellitus in Spain in patients with BMI ≥30 kg/m²

Cited by 17 publications

References 31 publications

Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain

Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain

A systematic review of economic evaluations in non-insulin antidiabetic treatments for patients with type 2 diabetes mellitus

Real-World Effectiveness of Liraglutide Versus Dulaglutide In Japanese Patients With Type 2 Diabetes: A Retrospective Study

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The cost-effectiveness of dulaglutide versus liraglutide for the treatment of type 2 diabetes mellitus in Spain in patients with BMI ≥30 kg/m2

Cited by 17 publications

References 31 publications

Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain

Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain

A systematic review of economic evaluations in non-insulin antidiabetic treatments for patients with type 2 diabetes mellitus

Real-World Effectiveness of Liraglutide Versus Dulaglutide In Japanese Patients With Type 2 Diabetes: A Retrospective Study

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The cost-effectiveness of dulaglutide versus liraglutide for the treatment of type 2 diabetes mellitus in Spain in patients with BMI ≥30 kg/m²