Nian Hua, Wan Xu, Ma Jing, Jie Fu, Wu Bin
1Department of Pharmacy, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
2Medical Decision and Economic Group, Department of Pharmacy, Ren Ji Hospital, South Campus, School of Medicine, Shanghai Jiaotong University, Jiangyue Road 2000, Shanghai, China.
Cost Eff Resour Alloc. 2020 Feb 28;18:12. doi: 10.1186/s12962-020-00208-w. eCollection 2020.
To investigate the long-term economic outcome of dapagliflozin versus metformin in Chinese patients with type 2 diabetes mellitus (T2DM) whose diet and exercise have not provided sufficient glycemic control.
An economic analysis of dapagliflozin versus metformin was conducted by using the Chinese Outcomes Model for T2DM with a time horizon of lifetime, which was developed and validated based on the Chinese population. The efficacy data of lowering HbA1c of dapagliflozin and metformin was derived from a network meta-analysis. Other clinical, cost and utility inputs were obtained from published sources. Lifetime discounted quality-adjusted life-years, cost, and incremental cost-effectiveness ratio were measured. The uncertainty was facilitated by one-way and probabilistic sensitivity analyses.
The comparison of metformin and dapagliflozin in Chinese patients with insufficient glycemic control by diet and exercise showed that dapagliflozin was more costly and produced fewer health benefits in our simulated cohort. The sensitivity analyses indicated that the results were robust.
Dapagliflozin is not likely to be cost-effective compared with metformin for Chinese patients with T2DM inadequately controlled with diet and exercise.
在中国2型糖尿病（T2DM）患者中，饮食和运动无法实现充分血糖控制，本研究旨在探讨达格列净与二甲双胍相比的长期经济结局。
采用基于中国人群开发并验证的中国2型糖尿病结局模型，对达格列净与二甲双胍进行了为期终身的经济分析。达格列净和二甲双胍降低糖化血红蛋白（HbA1c）的疗效数据来自网络荟萃分析。其他临床、成本和效用数据来自已发表的资料。测量了终身贴现质量调整生命年、成本和增量成本效益比。通过单向和概率敏感性分析来评估不确定性。
对于饮食和运动血糖控制不佳的中国患者，二甲双胍与达格列净的比较显示，在我们的模拟队列中，达格列净成本更高且产生的健康效益更少。敏感性分析表明结果具有稳健性。
对于饮食和运动控制不佳的中国T2DM患者，与二甲双胍相比，达格列净不太可能具有成本效益。
