[Cost-effectiveness of exenatide versus insulin glargine in Spanish patients with obesity and type 2 diabetes mellitus].
Author(s): Goodall G, Costi M, Timlin L, Reviriego J, Sacristan JA, Smith-Palmer J, Dilla T
Affiliation(s): IMS Health, Basilea, Suiza.
Publication date & source: 2011-08, Endocrinol Nutr., 58(7):331-40. Epub 2011 Jun 29.
Publication type: English Abstract
BACKGROUND AND OBJECTIVES: Exenatide, a GLP-1 receptor agonist for adjuvant treatment of type 2 diabetes mellitus (T2DM), has been shown to be as effective as insulin glargine (IG) for reducing glycated hemoglobin levels combined with metformin or/and sulphonylureas. Exenatide is associated to weight reduction and a higher incidence of gastrointestinal adverse events. The objective of this study was to assess the cost-effectiveness of exenatide as compared to IG in obese patients with T2DM not achieving an adequate blood glucose control from the perspective of the Spanish healthcare system. METHODS: Pharmacoeconomic model inputs were obtained from an obese subpopulation (BMI >/= 30 k/m(2)) of an international, randomized, controlled clinical trial comparing exenatide with IG in poorly controlled T2DM patients, and were supplemented with country-specific data. RESULTS: Exenatide was associated to improvements in life-years gained and quality-adjusted life years (QALYs) by 0.11 and 0.62 respectively versus IG. Direct costs were euro 9,306 higher as compared to IG (euro 47,010 versus euro 37,704, with increased pharmacy costs as the main driver). Exenatideis incremental cost-effectiveness ratio was euro 15,068 per QALY gained versus IG. CONCLUSIONS: Exenatide was associated to greater clinical benefits and higher costs in obese T2DM patients as compared to IG. Considering a willingness-to-pay threshold of euro 30,000 per QALY gained in the Spanish setting, exenatide represents an efficient option in comparison with IG. Copyright (c) 2010 SEEN. Published by Elsevier Espana. All rights reserved.