Zhang Huiyuan, Chen Jiaojiao, Zhao Quan, Zhang Bei
Department of Pharmacy, Yantai Yuhuangding Hospital, Yantai, Shandong, China.
Front Public Health. 2025 Jul 7;13:1566101. doi: 10.3389/fpubh.2025.1566101. eCollection 2025.
Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, performs a reduction in the all-cause mortality and cardiovascular mortality in type 2 diabetes mellitus (T2DM) patients compared to dapagliflozin, which has been included in the national volume-based procurement in China. The objective of this study is to evaluate the long-term cost-utility of the addition of empagliflozin (10 mg or 25 mg) versus dapagliflozin (10 mg) in T2DM patients with insufficient control by metformin monotherapy from the perspective of Chinese health care payers.
The IQVIA CORE diabetes model was used for cost-utility analysis to compare the long-term economics of empagliflozin (10 or 25 mg) versus dapagliflozin (10 mg) respectively. In the two independent analyses, the discount rate was 5% per year, and the utility value was derived from the published literatures. The baseline demographic and biochemical data, as well as treatment efficacy data were obtained from the EMPA-REG MET clinical trial and network meta-analysis, respectively.
Compared with dapagliflozin 10 mg, empagliflozin 10 mg and empagliflozin 25 mg improved the life expectancy by 0.011 and 0.02 years, and improved the quality adjusted life years (QALYs) by 0.011 and 0.02 years, respectively. The total cost of empagliflozin group (10 mg) was 279 Chinese Yuan lower than that of the dapagliflozin group (10 mg), making it an absolutely economical choice. The total cost of empagliflozin (25 mg) was expected to be 1,601 Chinese Yuan higher than dapagliflozin, with an incremental cost-utility ratio (ICUR) of 80,052 Chinese Yuan per QALY, below the set willingness to pay (WTP) threshold of 85,698 Chinese Yuan per QALY.
For T2DM patients with insufficient control by metformin monotherapy, the addition of empagliflozin 10 mg showed better efficacy and lower cost compared to dapagliflozin 10 mg, making it an absolutely economical choice. Based on the set WTP threshold, empagliflozin 25 mg was also a more cost-effective treatment option than dapagliflozin from the perspective of Chinese healthcare payers.
恩格列净是一种钠-葡萄糖协同转运蛋白2抑制剂，与达格列净相比，可降低2型糖尿病（T2DM）患者的全因死亡率和心血管死亡率，达格列净已被纳入中国国家集中采购。本研究的目的是从中国医疗保健支付方的角度，评估在二甲双胍单药治疗控制不佳的T2DM患者中加用恩格列净（10毫克或25毫克）与达格列净（10毫克）的长期成本效益。
使用IQVIA CORE糖尿病模型进行成本效益分析，以分别比较恩格列净（10毫克或25毫克）与达格列净（10毫克）的长期经济性。在两项独立分析中，贴现率为每年5%，效用值来自已发表的文献。基线人口统计学和生化数据以及治疗疗效数据分别来自EMPA-REG MET临床试验和网络荟萃分析。
与达格列净10毫克相比，恩格列净10毫克和恩格列净25毫克分别使预期寿命延长0.011年和0.02年，质量调整生命年（QALY）分别提高0.011年和0.02年。恩格列净组（10毫克）的总成本比达格列净组（10毫克）低279元，使其成为绝对经济的选择。恩格列净（25毫克）的总成本预计比达格列净高1601元，增量成本效益比（ICUR）为每QALY 80,052元，低于设定的每QALY支付意愿（WTP）阈值85,698元。
对于二甲双胍单药治疗控制不佳的T2DM患者，加用恩格列净10毫克与达格列净10毫克相比，疗效更好且成本更低，使其成为绝对经济的选择。基于设定的WTP阈值，从中国医疗保健支付方的角度来看，恩格列净25毫克也是比达格列净更具成本效益的治疗选择。
