Ferrario Maria Giovanna, Lizán Luis, Montagnoli Roberta, Ramírez de Arellano Antonio
Outcomes'10, Universidad Jaume I, Castellón, Spain.
EU-HEOR Novo Nordisk, Rome, Via Elio Vittorini, 129, Italy.
Prim Care Diabetes. 2016 Jun;10(3):220-6. doi: 10.1016/j.pcd.2015.10.002. Epub 2015 Nov 3.
To estimate the short-term cost-per-controlled-patient with type 2 diabetes mellitus with liraglutide 1.2mg/day vs. sitagliptin 100mg/day as add-on treatment to metformin in Italy.
The percentage of controlled patients, i.e. with "HbA1c<7% without hypoglycemia and weight gain", at 26 and 52 weeks with liraglutide and sitagliptin, as well as at 78 weeks for patients switching at 52 weeks from sitagliptin to liraglutide or hypothetically continuing on sitagliptin were obtained from randomized clinical trials (RCT) and a meta-analysis. The treatment cost-per-controlled-patient was calculated from the perspective of the National Health System over a 26, 52- and 78-week time horizon.
Despite the higher acquisition cost of liraglutide vs. sitagliptin, at 26 weeks liraglutide resulted in a lower cost-per-controlled-patient (€1460 vs. €1820 - with efficacy from RCT - and €1593 vs. €2234 - with efficacy from a meta-analysis), as well as at 52 weeks (€2627 vs. €2649). At 78 weeks, in patients who have switched from sitagliptin to liraglutide at 52 weeks, the cost-per-controlled-patient is also lower than that of patients continuing sitagliptin for 78 weeks (€2889 vs. €3970).
Due to higher efficacy, liraglutide is associated with better cost-benefit than sitagliptin at 26, 52 and 78 weeks.
评估在意大利,对于接受二甲双胍治疗的2型糖尿病患者,每日一次注射1.2mg利拉鲁肽与每日一次口服100mg西格列汀作为附加治疗方案时,每位血糖得到控制的患者的短期成本。
利拉鲁肽和西格列汀在26周和52周时,以及对于在52周时从西格列汀转换为利拉鲁肽或假设继续使用西格列汀治疗至78周的患者,血糖得到控制的患者(即“糖化血红蛋白<7%且无低血糖和体重增加”)的百分比,来自随机临床试验(RCT)和一项荟萃分析。从国家卫生系统的角度,在26周、52周和78周的时间范围内计算每位血糖得到控制的患者的治疗成本。
尽管利拉鲁肽的采购成本高于西格列汀,但在26周时,利拉鲁肽使每位血糖得到控制的患者的成本更低(RCT疗效数据下分别为1460欧元对1820欧元;荟萃分析疗效数据下分别为1593欧元对2234欧元),在52周时也是如此(2627欧元对2649欧元)。在78周时, 对于在52周时从西格列汀转换为利拉鲁肽的患者,每位血糖得到控制的患者的成本也低于继续使用西格列汀治疗78周的患者(2889欧元对3970欧元)。
由于疗效更高,在26周、52周和78周时,利拉鲁肽比西格列汀具有更好的成本效益。