Ghetti Gianni, Pradelli Lorenzo, Papageorgiou Giannis, Karpouzos George, Arikan Yelda
AdRes Health Economics and Outcome Research, Turin, Italy.
Boehringer Ingelheim Hellas, Athens, Greece.
Clinicoecon Outcomes Res. 2023 Feb 17;15:97-109. doi: 10.2147/CEOR.S400522. eCollection 2023.
Globally, the prevalence of diabetes is on the rise, with the number of affected individuals predicted to cross 700 million by 2045. In Greece, in 2015, almost 700,000 people received prescribed medication for type 2 diabetes. The CELESTIA study aims to assess the cost-effectiveness of empagliflozin compared to branded sitagliptin in type 2 diabetes patients both with and without established cardiovascular disease in Greece from a third payer perspective.
The IQVIA Core Diabetes Model was used and analyses were conducted from the Greek healthcare payer perspective. Patients received either empagliflozin or sitagliptin until HbA1c threshold of 8.5% (69 mmol/mol) was exceeded. Subsequently, patients were assumed to intensify to insulin therapy. Baseline cohort characteristics and treatment effects were derived from clinical trial data. Literature data were used for input (utilities, treatment costs and costs of diabetes-related complications costs). A lifetime time horizon (50 years) was applied, and costs and benefits were discounted at an annual rate of 3.5%.
Over a lifetime horizon, for empagliflozin, the estimated ICER was of €6,587 and €966 per quality-adjusted life years gained versus sitagliptin, in patients without established cardiovascular disease and in patients with established cardiovascular disease, respectively. Probabilistic sensitivity analysis confirmed the robustness of the analysis.
The analysis demonstrated that for type 2 diabetes patients, empagliflozin is a cost-effective treatment option versus branded sitagliptin in Greece.
在全球范围内，糖尿病的患病率正在上升，预计到2045年受影响个体的数量将超过7亿。在希腊，2015年有近70万人接受了2型糖尿病的处方药治疗。CELESTIA研究旨在从第三方支付者的角度评估在希腊患有和未患有已确诊心血管疾病的2型糖尿病患者中，恩格列净与品牌西他列汀相比的成本效益。
使用IQVIA核心糖尿病模型，并从希腊医疗保健支付者的角度进行分析。患者接受恩格列净或西他列汀治疗，直到糖化血红蛋白（HbA1c）阈值超过8.5%（69 mmol/mol）。随后，假设患者强化胰岛素治疗。基线队列特征和治疗效果来自临床试验数据。文献数据用于输入（效用、治疗成本和糖尿病相关并发症成本）。采用50年的终生时间范围，成本和效益按每年3.5%的贴现率进行贴现。
在终生时间范围内，对于恩格列净，在未患有已确诊心血管疾病的患者和患有已确诊心血管疾病的患者中，与西他列汀相比，每获得一个质量调整生命年的估计增量成本效果比分别为6587欧元和966欧元。概率敏感性分析证实了该分析的稳健性。
分析表明，对于2型糖尿病患者，在希腊，与品牌西他列汀相比，恩格列净是一种具有成本效益的治疗选择。
