McCrimmon Rory J, Falla Edel, Sha Jo Zhou, Alsaleh Abdul Jabbar Omar, Lew Elisheva, Hudson Richard, Baxter Mike, Palmer Karen
School of Medicine, University of Dundee, Dundee, UK.
IQVIA, Real-World Solutions, London, UK.
Diabetes Ther. 2021 Dec;12(12):3217-3230. doi: 10.1007/s13300-021-01159-y. Epub 2021 Oct 29.
A cost-effectiveness analysis was conducted comparing a fixed-ratio combination (FRC) of insulin glargine 100 units/mL plus lixisenatide (iGlarLixi) versus the FRC of insulin degludec plus liraglutide (iDegLira) and the free-combination comparators insulin glargine plus dulaglutide (iGlar plus Dula) and basal insulin plus liraglutide (BI plus Lira).
The IQVIA Core Diabetes Model was used to estimate lifetime costs and outcomes for a cohort of patients with type 2 diabetes mellitus (T2DM) from the UK healthcare perspective. Initial clinical data for iGlarLixi were based on the randomized, controlled LixiLan-L trial and the relative treatment effects for comparators were based on an indirect treatment comparison using data from the AWARD-9 (iGlar plus Dula), LIRA ADD2 BASAL (BI plus Lira), and DUAL V (iDegLira) trials. Costs were derived from publicly available sources. Lifetime costs (in British Pound Sterling [£]) and quality-adjusted life-years (QALYs) were predicted; net monetary benefit (NMB) for iGlarLixi versus comparators was derived using a willingness-to-pay threshold of £20,000. Extensive scenario and sensitivity analyses were conducted.
Estimated costs were lowest with iGlarLixi (£31,295) compared with iGlar plus Dula (£38,790), iDegLira (£40,179), and BI plus Lira (£42,467). Total QALYs gained were identical with iGlarLixi and iDegLira (8.438), and comparable with iGlar plus Dula (8.439) and BI plus Lira (8.466). NMB for iGlarLixi was positive versus all comparators (£10,603.86 vs. BI plus Lira; £7,466.24 vs. iGlar plus Dula; £8.874.11 vs. iDegLira).
In patients with T2DM with suboptimal glycemic control on basal insulin, iGlarLixi provides very similar outcomes and substantial cost savings, compared with other fixed and free combinations of insulins plus glucagon-like peptide-1 receptor agonists.
进行了一项成本效益分析，比较了甘精胰岛素100单位/毫升与利司那肽的固定比例组合（iGlarLixi）、德谷胰岛素与利拉鲁肽的固定比例组合（iDegLira）以及自由组合对照药物甘精胰岛素与度拉糖肽（iGlar加Dula）和基础胰岛素与利拉鲁肽（基础胰岛素加Lira）。
从英国医疗保健角度出发，使用IQVIA核心糖尿病模型估算2型糖尿病（T2DM）患者队列的终生成本和结局。iGlarLixi的初始临床数据基于随机对照的LixiLan-L试验，对照药物的相对治疗效果基于使用来自AWARD-9（iGlar加Dula）、LIRA ADD2 BASAL（基础胰岛素加Lira）和DUAL V（iDegLira）试验数据的间接治疗比较。成本来自公开可用来源。预测终生成本（以英镑[£]计）和质量调整生命年（QALY）；使用20,000英镑的支付意愿阈值得出iGlarLixi与对照药物相比的净货币效益（NMB）。进行了广泛的情景分析和敏感性分析。
与iGlar加Dula（38,790英镑）、iDegLira（40,179英镑）和基础胰岛素加Lira（42,467英镑）相比，iGlarLixi的估计成本最低（31,295英镑）。iGlarLixi和iDegLira获得的总QALY相同（8.438），与iGlar加Dula（8.439）和基础胰岛素加Lira（8.466）相当。iGlarLixi与所有对照药物相比的NMB为正值（与基础胰岛素加Lira相比为10,603.86英镑；与iGlar加Dula相比为7,466.24英镑；与iDegLira相比为8,874.11英镑）。
在基础胰岛素治疗下血糖控制欠佳的T2DM患者中，与胰岛素加胰高血糖素样肽-1受体激动剂的其他固定和自由组合相比，iGlarLixi提供了非常相似的结局并节省了大量成本。
