Utilities and disutilities for type 2 diabetes treatment-related attributes

Matza, Louis S.; Boye, Kristina S.; Yurgin, Nicole; Brewster‐Jordan, Jessica; Mannix, Sally; Shorr, Jodi M.; Barber, Beth

doi:10.1007/s11136-007-9226-0

Cited by 106 publications

(110 citation statements)

References 69 publications

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“…Treatment discontinuations were assigned a QALY decrement associated with nausea as drawn from Matza et al 214 The with-and without-nausea QoL values of 0.85 and 0.89 were taken to apply yielding a mean decrement of 0.04, which the GDG thought a 6-week duration would be most reasonable estimate, this yielding a mean QALY decrement of -0.00462.…”

Section: Quality Of Life: Treatment Discontinuationsmentioning

confidence: 99%

Canagliflozin, dapagliflozin and empagliflozin monotherapy for treating type 2 diabetes: systematic review and economic evaluation

Johnston

Uthman

Cummins

et al. 2017

Health Technol Assess

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Background Most people with type 2 diabetes are overweight, so initial treatment is aimed at reducing weight and increasing physical activity. Even modest weight loss can improve control of blood glucose. If drug treatment is necessary, the drug of first choice is metformin. However, some people cannot tolerate metformin, which causes diarrhoea in about 10%, and it cannot be used in people with renal impairment. This review appraises three of the newest class of drugs for monotherapy when metformin cannot be used, the sodium–glucose co-transporter 2 (SGLT2) inhibitors. Objective To review the clinical effectiveness and cost-effectiveness of dapagliflozin (Farxiga, Bristol-Myers Squibb, Luton, UK), canagliflozin (Invokana, Janssen, High Wycombe, UK) and empagliflozin (Jardiance, Boehringer Ingelheim, Ingelheim, Germany/Eli Lilly and Company, Indianapolis, IN, USA), in monotherapy in people who cannot take metformin. Sources MEDLINE (1946 to February 2015) and EMBASE (1974 to February 2015) for randomised controlled trials lasting 24 weeks or more. For adverse events, a wider range of studies was used. Three manufacturers provided submissions. Methods Systematic review and economic evaluation. A network meta-analysis was carried out involving the three SGLT2 inhibitors and key comparators. Critical appraisal of submissions from three manufacturers. Results We included three trials of dapagliflozin and two each for canagliflozin and empagliflozin. The trials were of good quality. The canagliflozin and dapagliflozin trials compared them with placebo, but the two empagliflozin trials included active comparators. All three drugs were shown to be effective in improving glycaemic control, promoting weight loss and lowering blood pressure (BP). Limitations There were no head-to-head trials of the different flozins, and no long-term data on cardiovascular outcomes in this group of patients. Most trials were against placebo. The trials were done in patient groups that were not always comparable, for example in baseline glycated haemoglobin or body mass index. Data on elderly patients were lacking. Conclusions Dapagliflozin, canagliflozin and empagliflozin are effective in improving glycaemic control, with added benefits of some reductions in BP and weight. Adverse effects are urinary and genital tract infections in a small proportion of users. In monotherapy, the three drugs do not appear cost-effective compared with gliclazide or pioglitazone, but may be competitive against sitagliptin (Januvia, Merck Sharp & Dohme Limited, Kenilworth, NJ, USA). Funding The National Institute for Health Research Health Technology Assessment programme.

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Section: Quality Of Life: Treatment Discontinuationsmentioning

confidence: 99%

Canagliflozin, dapagliflozin and empagliflozin monotherapy for treating type 2 diabetes: systematic review and economic evaluation

Johnston

Uthman

Cummins

et al. 2017

Health Technol Assess

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“…41 Estimates of the impact of fear on utility scores, however, have varied considerably. [41][42][43][44][45] Because patients with poorly controlled diabetes are more likely to have hypoglycemia, it is uncertain whether the lower utility scores that have been reported are attributable to hypoglycemia and fear of future episodes or to severity of disease. 41 Moreover, the Center for Outcomes Research Diabetes Model 6 accommodates fear of hypoglycemia by applying a chronic decrement to health-related quality-oflife scores in the conventional-insulin arm, but not in the insulin-analogue arm.…”

Section: Outcome Measuresmentioning

confidence: 99%

Cost-effectiveness of insulin analogues for diabetes mellitus

Cameron¹,

Bennett²

2009

Canadian Medical Association Journal

100

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Insulin agents available for the treatment of diabetes mellitus include conventional insulins and insulin analogues. Insulin analogues were developed to mimic more closely the separate bolus and basal components of insulin secretion.1 Rapid-acting (bolus or mealtime) and longacting (basal or background) analogue formulations are available. This new class of drugs has been promoted as providing more flexible treatment schedules and a reduced risk of hypoglycemia relative to conventional insulins. 1The cost of insulin analogues exceeds that of conventional insulins.2,3 More than US$7.3 billion was spent globally on the purchase of insulin products in 2005 -an increase of 19% over the previous year.4 It has been suggested that the increased expenditure was due to both the increasing prevalence of diabetes and the increased use of insulin analogues. 5 We performed an analysis of the cost-effectiveness of insulin analogues compared with conventional insulins in the management of type 1 or type 2 diabetes in adults. MethodsThe economic model We used the Center for Outcomes Research Diabetes Model 6 to calculate the cost-effectiveness estimates. This model, described in detail by Palmer and colleagues, 6 has been validated against published clinical and epidemiologic studies (Figure 1). 7 Using data derived from the published literature, the model uses mathematical equations to determine the diabetes-related complications that would occur throughout a patient's life span. 6 The equations take into consideration risk factors such as age and hemoglobin A 1c levels, as well as patient characteristics, type of diabetes and history of diabetesrelated complications. 6 For type 1 and type 2 diabetes, correlation analyses produced R 2 estimates of 0.9778 and 0.8861, which demonstrate that simulations in the Center for Outcomes Research Diabetes Model 6 provide a reasonably accurate representation of patient outcomes in real-life settings. 7 We derived the clinical effects of therapy (hemoglobin A 1c , mild to moderate hypoglycemia and severe hypoglycemia), required as inputs for the model, from meta-analyses of randomized controlled trials (Table 1). [8][9][10] We compared rapidacting insulin analogues (insulin aspart and insulin lispro) with regular human insulin. We compared long-acting analogues (insulin glargine and insulin detemir) with neutral protamine Hagedorn insulin. For treatment comparisons, we

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“…These methods were based on those of two previous studies that were conducted to estimate utilities associated with attributes of injectable treatments for T2D. 20,21 The utilities reported in these previous publications have been used in multiple published CUAs of treatments for T2D. [22][23][24][25] Utilities were estimated using health state descriptions because the vignette-based approach is well-suited for isolating the impact of specific treatment-related attributes on utility.…”

Section: Overview Of Study Designmentioning

confidence: 99%

Patient Preferences In Italy: Health State Utilities Associated With Attributes Of Weekly Injection Devices For Treatment Of Type 2 Diabetes

et al. 2017

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Utilities and disutilities for type 2 diabetes treatment-related attributes

Abstract: The vignette-based approach was feasible and useful for assessing added utility or disutility of medication-related attributes.

Cited by 106 publications

References 69 publications

Canagliflozin, dapagliflozin and empagliflozin monotherapy for treating type 2 diabetes: systematic review and economic evaluation

Canagliflozin, dapagliflozin and empagliflozin monotherapy for treating type 2 diabetes: systematic review and economic evaluation

Cost-effectiveness of insulin analogues for diabetes mellitus

Patient Preferences In Italy: Health State Utilities Associated With Attributes Of Weekly Injection Devices For Treatment Of Type 2 Diabetes

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