Basson Mickael, Ntais Dionysios, Ayyub Ruba, Wright Donna, Lowin Julia, Chartier Florence, Roze Stéphane, Norrbacka Kirsi
Eli Lilly, Neuilly-sur-Seine, France.
QuintilesIMS, London, UK.
Diabetes Ther. 2018 Feb;9(1):13-25. doi: 10.1007/s13300-017-0321-0. Epub 2017 Nov 13.
Dulaglutide is a novel onceweekly administered glucagon-like peptide 1 receptor agonist (GLP-1 RA) for the management of type 2 diabetes mellitus (T2DM). The objective of this analysis was to estimate the cost-effectiveness of dulaglutide 1.5 mg versus exenatide QW for the management of T2DM in France.
The QuintilesIMS CORE Diabetes Model was used to estimate the expected lifetime direct medical costs and outcomes of T2DM from the perspective of the French National Health Service. In the absence of head-to-head data, relative efficacy was derived from a network meta-analysis. Patient cohort characteristics were derived from the AWARD-2 trial. All patients were assumed to remain on treatment for 2 years before escalating to insulin therapy. Costs included treatment costs and costs associated with long-term complications of T2DM. Utilities were estimated based on a recent systematic review. One-way sensitivity analyses (OWSA) and probabilistic sensitivity analysis (PSA) were conducted. Cost-effectiveness acceptability curves (CEACs) were generated.
Dulaglutide 1.5 mg was associated with lower costs (lifetime costs €41,562 vs €43,021) and increased health benefits (lifetime quality-adjusted life years: QALYs 9.804 vs 9.757) versus exenatide QW for the treatment of T2DM in France. OWSA and PSA indicated that results were robust across a range of plausible input parameters. The CEAC indicated a 99.5% probability that dulaglutide would be considered cost-effective at a willingness to pay of €30,000.
Dulaglutide 1.5 mg reduced expected costs and increased expected QALYs when compared against exenatide QW for the treatment of T2DM in France. Compared with exenatide QW, dulaglutide 1.5 mg can provide additional health benefits for patients with T2DM and may result in cost savings for payers.
Eli Lilly.
度拉糖肽是一种新型的每周一次给药的胰高血糖素样肽-1受体激动剂（GLP-1 RA），用于治疗2型糖尿病（T2DM）。本分析的目的是评估度拉糖肽1.5毫克与艾塞那肽每周一次给药方案在法国治疗T2DM的成本效益。
采用昆泰IMS核心糖尿病模型，从法国国家医疗服务体系的角度估算T2DM的预期终身直接医疗成本和治疗效果。在缺乏直接对比数据的情况下，相对疗效来自网络荟萃分析。患者队列特征来自AWARD-2试验。所有患者假定在升级为胰岛素治疗前持续治疗2年。成本包括治疗成本以及与T2DM长期并发症相关的成本。效用值基于近期的一项系统评价进行估算。进行了单因素敏感性分析（OWSA）和概率敏感性分析（PSA）。生成了成本效益可接受性曲线（CEAC）。
在法国治疗T2DM时，与艾塞那肽每周一次给药方案相比，度拉糖肽1.5毫克的成本更低（终身成本41,562欧元对43,021欧元），健康效益更高（终身质量调整生命年：QALYs 9.804对9.757）。OWSA和PSA表明，在一系列合理的输入参数范围内，结果是稳健的。CEAC表明，在支付意愿为30,000欧元时；度拉糖肽被认为具有成本效益的概率为99.5%。
在法国治疗T2DM时，与艾塞那肽每周一次给药方案相比，度拉糖肽1.5毫克降低了预期成本，提高了预期QALYs。与艾塞那肽每周一次给药方案相比，度拉糖肽1.5毫克可为T2DM患者提供额外的健康效益，并可能为支付方节省成本。
礼来公司。
