De Oliveira Gustavo Laine Araujo, Guerra Júnior Augusto Afonso, Godman Brian, Acurcio Francisco de Assis
a Department of Social Pharmacy, School of Pharmacy , Federal University of Minas Gerais , Belo Horizonte , Brazil.
b Department of Management and Incorporation of Health Technology , Ministry of Health , Brasilia , Brazil.
Expert Rev Pharmacoecon Outcomes Res. 2017 Apr;17(2):109-119. doi: 10.1080/14737167.2017.1292852. Epub 2017 Feb 22.
Vildagliptin is an inhibitor of the enzyme dipeptidyl peptidase 4, indicated for the treatment of type 2 diabetes mellitus, combined or not with metformin. This study aims to evaluate the cost-effectiveness of vildagliptin in the Brazilian context. Areas covered: Using MEDLINE, Cochrane Library, Lilacs and CRD, six studies were selected for the economic models. This study utilised cost data in the Brazilian health system to provide the context. Expert commentary: Type 2 diabetes mellitus is an epidemic disease and represents a challenge for all health care systems. Although guidelines clearly define first-line treatment, there are several other promising treatments. Vildagliptin is one of them, resulting in a mean lifetime increase of 0.31 years compared to metformin alone and 1.19 more life years compared to other metformin combinations. Considering observational data, life years with dual vildagliptin-containing treatments were 0.37 more compared to other dual treatments. However, its high cost versus generic metformin and its unclear safety profile weakens its subsequent cost-effectiveness. Consequently, the incorporation of vildagliptin or its combination with metformin is currently not recommended for the Brazilian Health Care System. This may change as more data becomes available.
维格列汀是二肽基肽酶4的抑制剂，适用于治疗2型糖尿病，可与二甲双胍联合使用，也可单独使用。本研究旨在评估维格列汀在巴西背景下的成本效益。涵盖领域：通过检索MEDLINE、Cochrane图书馆、Lilacs和CRD，选取了六项研究用于构建经济模型。本研究利用了巴西卫生系统中的成本数据来提供背景信息。专家评论：2型糖尿病是一种流行病，对所有医疗保健系统都是一项挑战。尽管指南明确规定了一线治疗方法，但还有其他几种有前景的治疗方法。维格列汀就是其中之一，与单独使用二甲双胍相比，其平均寿命延长0.31年，与其他二甲双胍联合用药相比，多延长1.19个生命年。根据观察数据，与其他双重治疗相比，含维格列汀的双重治疗的生命年多0.37年。然而，与普通二甲双胍相比，其成本高昂，且安全性尚不明确，这削弱了其后续的成本效益。因此，目前不建议巴西医疗保健系统采用维格列汀或其与二甲双胍的联合用药。随着更多数据的出现，这种情况可能会改变。
