Department of Cardiovascular Sciences, University of Leicester, UK.
Diabet Med. 2012 Mar;29(3):313-20. doi: 10.1111/j.1464-5491.2011.03429.x.
To investigate the cost-effectiveness of liraglutide as add-on to metformin vs. glimepiride or sitagliptin in patients with Type 2 diabetes uncontrolled with first-line metformin.
Data were sourced from a clinical trial comparing liraglutide vs. glimepiride, both in combination with metformin, and a clinical trial comparing liraglutide vs. sitagliptin, both as add-on to metformin. Only the subgroup of patients in whom liraglutide was added to metformin monotherapy was included in the cost-utility analysis. The CORE Diabetes Model was used to simulate outcomes and costs with liraglutide 1.2 and 1.8 mg vs. glimepiride and vs. sitagliptin over patients' lifetimes. Treatment effects were taken directly from the trials. Costs and outcomes were discounted at 3.5% per annum and costs were accounted from a third-party payer (UK National Health System) perspective.
Treatment with liraglutide 1.2 and 1.8 mg resulted, respectively, in mean increases in quality-adjusted life expectancy of 0.32 ± 0.15 and 0.28 ± 0.14 quality-adjusted life years vs. glimepiride, and 0.19 ± 0.15 and 0.31 ± 0.15 quality-adjusted life years vs. sitagliptin, and was associated with higher costs of £ 3003 ± £ 678 and £ 4688 ± £ 639 vs. glimepiride, and £ 1842 ± £ 751 and £ 3224 ± £ 683 vs. sitagliptin, over a patient's lifetime. Both liraglutide doses were cost-effective, with incremental cost-effectiveness ratios of £ 9449 and £ 16,501 per quality-adjusted life year gained vs. glimepiride, and £ 9851 and £ 10,465 per quality-adjusted life year gained vs. sitagliptin, respectively.
Liraglutide, added to metformin monotherapy, is a cost-effective option for the treatment of Type 2 diabetes in a UK setting.
研究利拉鲁肽联合二甲双胍对比格列美脲或西格列汀添加治疗二甲双胍单药控制不佳的 2 型糖尿病患者的成本效果。
数据来源于比较利拉鲁肽联合二甲双胍与格列美脲，以及比较利拉鲁肽联合二甲双胍与西格列汀的临床试验。仅将利拉鲁肽添加到二甲双胍单药治疗的患者亚组纳入成本效用分析。采用 CORE 糖尿病模型模拟利拉鲁肽 1.2mg 和 1.8mg 对比格列美脲和西格列汀在患者一生中的疗效和成本。治疗效果直接取自试验。成本和结果以每年 3.5%贴现，从第三方付款人（英国国家医疗服务体系）的角度考虑成本。
利拉鲁肽 1.2mg 和 1.8mg 治疗组与格列美脲相比，分别使质量调整预期寿命平均增加 0.32 ± 0.15 和 0.28 ± 0.14 个质量调整生命年，与西格列汀相比，分别使质量调整预期寿命平均增加 0.19 ± 0.15 和 0.31 ± 0.15 个质量调整生命年，而成本分别增加 3003 ± 678 英镑和 4688 ± 639 英镑，以及 1842 ± 751 英镑和 3224 ± 683 英镑。在患者一生中，两种利拉鲁肽剂量均具有成本效果，增量成本效果比分别为每获得 1 个质量调整生命年的 9449 英镑和 16501 英镑对比格列美脲，以及每获得 1 个质量调整生命年的 9851 英镑和 10465 英镑对比西格列汀。
在英国，利拉鲁肽添加到二甲双胍单药治疗中是治疗 2 型糖尿病的一种具有成本效果的选择。
