Incretin therapy for type 2 diabetes in Spain : A cost-effectiveness analysis of liraglutide versus sitagliptin
Mezquita Raya, Pedro (Hospital Universitario Torrecárdenas (Almeria, Andalusia))
Pérez Pérez, Antonio (Institut d'Investigació Biomèdica Sant Pau)
Ramírez De Arellano, Antonio (Novo Nordisk (Madrid))
Briones, Teresa (Novo Nordisk (Madrid))
Hunt, Barnaby (Ossian Health Economics and Communications (Suïssa))
Valentine, William J. (Ossian Health Economics and Communications (Suïssa))
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2013
Resum:	Introduction: Treatment with glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors, which target the incretin axis, has the potential to improve glycemic control in type 2 diabetes patients without the weight gain associated with traditional therapies. To evaluate the relative cost-effectiveness of incretin therapies, the present study aimed to compare the long-term clinical and cost implications associated with liraglutide and sitagliptin in type 2 diabetes patients in Spain. Methods: Data were taken from a randomized, controlled trial (NCT00700817) in which adults with type 2 diabetes failing metformin monotherapy were randomly allocated to receive either liraglutide 1. 2 mg or sitagliptin 100 mg daily in addition to metformin. Long-term projections of clinical outcomes and direct costs (2012 EUR) based on observed treatment effects were made using a published and validated type 2 diabetes model. Costs were taken from published sources. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed. Results: Liraglutide was associated with improved discounted life expectancy (14. 05 versus 13. 91 years) and quality-adjusted life expectancy [9. 04 versus 8. 87 quality-adjusted life years (QALYs)] compared to sitagliptin. Improved clinical outcomes were driven by improved glycemic control, leading to reduced incidence of diabetes-related complications, including renal disease, cardiovascular disease, ophthalmic and diabetic foot complications. Liraglutide was associated with increased direct costs of EUR 2,297, yielding an incremental cost-effectiveness ratio of EUR 13,266 per QALY gained versus sitagliptin. Conclusions: Liraglutide was projected to improve life expectancy, quality-adjusted life expectancy and reduce incidence of diabetesrelated complication. Liraglutide is likely to be cost-effective versus sitagliptin from a healthcare payer perspective in Spain. © The Author(s) 2013.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Diabetes Therapy, Vol. 4 Núm. 2 (december 2013) , p. 417-430, ISSN 1869-6961

DOI: 10.1007/s13300-013-0044-9
PMID: 24132613

14 p, 460.6 KB

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