Dataset Information
Cost-utility analysis of glucagon-like Peptide-1 agonists compared with dipeptidyl peptidase-4 inhibitors or neutral protamine hagedorn Basal insulin as add-on to metformin in type 2 diabetes in sweden.
Ontology highlight
ABSTRACT: Introduction
This study aimed to assess the costs and benefits of three alternative second-line treatment strategies for Swedish patients with type 2 diabetes mellitus (T2DM) who fail to reach glycated hemoglobin (HbA1c) ? 7% with metformin treatment alone: glucagon-like peptide-1 (GLP-1) receptor agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and neutral protamine Hagedorn (NPH) insulin.Methods
A previously developed cohort model for T2DM was applied over a 35-year time horizon. Data on T2DM patients on metformin monotherapy with HbA1c > 7% were collected from the Swedish National Diabetes Register. Treatment effects were taken from published studies. Costs and effects were discounted at 3% per annum, and the analysis was conducted from a societal perspective. The robustness of the results was evaluated using one-way and probabilistic sensitivity analyses.Results
Treatment with GLP-1 agonists was associated with a discounted incremental benefit of 0.10 and 0.25 quality-adjusted life years (QALYs) and higher discounted costs of Swedish Krona (SEK) 34,865 and SEK 40,802 compared with DPP-4 inhibitors and NPH insulin, respectively. Assuming willingness-to-pay (WTP) of SEK 500,000 per QALY, treatment strategy with GLP-1 agonists was a cost-effective option with incremental cost-effectiveness ratios of SEK 353,172 and SEK 160,618 per QALY gained versus DPP-4 inhibitors and NPH insulin, respectively. The results were most sensitive to incidence rate of moderate/major hypoglycemia and disutilities associated with insulin treatment, body mass index (BMI), and hypoglycemia.Conclusion
Assuming a WTP of SEK 500,000 per QALY, treatment strategy with GLP-1 agonists is a cost-effective strategy in comparison to DPP-4 inhibitors and NPH insulin among T2DM patients inadequately controlled with metformin alone in a Swedish setting.
SUBMITTER: Kiadaliri AA
PROVIDER: S-EPMC4269657 | biostudies-literature | 2014 Dec
REPOSITORIES: biostudies-literature
Publications
Cost-utility analysis of glucagon-like Peptide-1 agonists compared with dipeptidyl peptidase-4 inhibitors or neutral protamine hagedorn Basal insulin as add-on to metformin in type 2 diabetes in sweden.
Diabetes therapy : research, treatment and education of diabetes and related disorders 20140912 2
<h4>Introduction</h4>This study aimed to assess the costs and benefits of three alternative second-line treatment strategies for Swedish patients with type 2 diabetes mellitus (T2DM) who fail to reach glycated hemoglobin (HbA1c) ≤ 7% with metformin treatment alone: glucagon-like peptide-1 (GLP-1) receptor agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and neutral protamine Hagedorn (NPH) insulin.<h4>Methods</h4>A previously developed cohort model for T2DM was applied over a 35-year time ho ...[more]