Ossian Health Economics and Communications, Basel, Switzerland.
Ossian Health Economics and Communications, Basel, Switzerland.
Diabetes Res Clin Pract. 2021 May;175:108759. doi: 10.1016/j.diabres.2021.108759. Epub 2021 Mar 17.
To assess the long-term cost-effectiveness of novel glucagon-like peptide-1 (GLP-1) analog oral semaglutide versus sodium-glucose cotransporter-2 inhibitor empagliflozin, dipeptidyl peptidase-4 inhibitor sitagliptin and injectable GLP-1 analog liraglutide in the Netherlands, based on the results of the PIONEER clinical trials.
Outcomes were projected over patient lifetimes using the IQVIA CORE Diabetes Model. Clinical data were derived from PIONEER 2, 3 and 4. Patients were assumed to receive initial treatments until glycated hemoglobin exceeded 7.5%, then treatment-intensified to basal insulin therapy. Costs were accounted from a societal perspective in 2019 euros (EUR).
Oral semaglutide 14 mg was associated with improvements in quality-adjusted life expectancy of 0.15, 0.22 and 0.09quality-adjusted life years (QALYs) versus empagliflozin 25 mg, sitagliptin 100 mg and liraglutide 1.8 mg, respectively, with combined costs EUR1,032 higher, EUR115 higher and EUR1,267 lower. Oral semaglutide was therefore associated with incremental cost-effectiveness ratios of EUR7,061 and EUR516 per QALY gained versus empagliflozin and sitagliptin, respectively.
Based on long-term projections, oral semaglutide 14 mg was considered cost-effective versus empagliflozin 25 mg and sitagliptin 100 mg and dominant versus liraglutide 1.8 mg for the treatment of type 2 diabetes in the Netherlands.
根据 PIONEER 临床试验结果，评估新型胰高血糖素样肽-1（GLP-1）类似物口服司美格鲁肽相对于钠-葡萄糖协同转运蛋白-2 抑制剂恩格列净、二肽基肽酶-4 抑制剂西格列汀和注射用 GLP-1 类似物利拉鲁肽在荷兰的长期成本效益。
使用 IQVIA CORE Diabetes Model 对患者的终生结果进行预测。临床数据来自 PIONEER 2、3 和 4 期研究。假设患者接受初始治疗直至糖化血红蛋白（HbA1c）超过 7.5%，然后强化治疗至基础胰岛素治疗。成本从 2019 年的社会角度进行核算（欧元）。
口服司美格鲁肽 14mg 与恩格列净 25mg、西格列汀 100mg 和利拉鲁肽 1.8mg 相比，分别使调整后的期望寿命延长了 0.15、0.22 和 0.09 个质量调整生命年（QALY），同时增加了 1032 欧元的综合成本，增加了 115 欧元和降低了 1267 欧元。因此，口服司美格鲁肽与恩格列净和西格列汀相比，分别具有每获得一个 QALY 增量成本效益比为 7061 欧元和 516 欧元的优势。
基于长期预测，在荷兰，与恩格列净 25mg 和西格列汀 100mg 相比，口服司美格鲁肽 14mg 被认为是治疗 2 型糖尿病的一种具有成本效益的治疗方法，并且优于利拉鲁肽 1.8mg。
