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Evaluating the Long-Term Cost-Effectiveness of Liraglutide Versus Exenatide BID in Patients With Type 2 Diabetes Who Fail to Improve With Oral Antidiabetic Agents
Citation
Valentine, WJ and Palmer, AJ and Lammert, M and Langer, J and Brandle, M, Evaluating the Long-Term Cost-Effectiveness of Liraglutide Versus Exenatide BID in Patients With Type 2 Diabetes Who Fail to Improve With Oral Antidiabetic Agents, Clinical Therapeutics: The International, Peer-Reviewed Journal of Drug Therapy, 33, (11) pp. 1698-1712. ISSN 0149-2918 (2011) [Refereed Article]
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Copyright Statement
Copyright 2011 Elsevier HS Journals, Inc.
DOI: doi:10.1016/j.clinthera.2011.09.022
Abstract
Background: The global clinical and economic burden
of type 2 diabetes is substantial. Recently, clinical
trials with glucagon-like peptide-1 (GLP-1) receptor
agonists (liraglutide and exenatide) have shown a multifactorial
clinical profile with the potential to address
many of the clinical needs of patients and reduce the
burden of disease.
Objective: The goal of this study was to evaluate
the long-term cost-effectiveness of once-daily liraglutide
versus exenatide BID in patients with type 2
diabetes who failed to improve with metformin and/or
sulfonylurea, based on the results of a previous clinical
trial in 6 European countries (Switzerland, Denmark,
Norway, Finland, the Netherlands, and Austria).
Methods: A validated computer simulation model
of diabetes was used to predict life expectancy, qualityadjusted
life years (QALYs), and incidence of diabetesrelated
complications in patients receiving liraglutide
(1.8 mg once daily) or exenatide (10 g BID). Baseline
cohort characteristics and treatment effects were derived
from the Liraglutide Effect and Action in Diabetes
6 trial. Country-specific complication costs were
taken from published sources. Simulations were run
over 40 years from third-party payer perspectives. Future
costs and clinical benefits were discounted at
country-specific discount rates. Sensitivity analyses
were performed.
Results: Liraglutide was associated with improvements
of 0.12 to 0.17 QALY and a reduced incidence
of most diabetes-related complications versus exenatide
in all settings. Evaluation of total direct medical
costs (treatment plus complication costs) suggest
that liraglutide was likely to cost between Euro (€)
1023 and €1866 more than exenatide over patients’
lifetimes, leading to incremental cost-effectiveness
ratios per QALY gained versus exenatide of: Switzerland,
CHF (Swiss francs) 10,950 (€6902); Denmark,
Danish krone [kr] 88,160 (€11,805); Norway, Norwegian
krone [kr], 111,916 (€13,546); Finland, €8459;
the Netherlands, €8119; and Austria, €8516.
Conclusions: Long-term projections indicated that
liraglutide was associated with benefits in life expectancy,
QALYs, and reduced complication rates versus
exenatide. Liraglutide was cost-effective from a
health care payer perspective in Switzerland, Denmark,
Norway, Finland, the Netherlands, and Austria.
Item Details
Item Type: | Refereed Article |
---|---|
Keywords: | costs, cost-effectiveness, exenatide, liraglutide, type 2 diabetes |
Research Division: | Biomedical and Clinical Sciences |
Research Group: | Clinical sciences |
Research Field: | Endocrinology |
Objective Division: | Health |
Objective Group: | Evaluation of health and support services |
Objective Field: | Evaluation of health and support services not elsewhere classified |
UTAS Author: | Palmer, AJ (Professor Andrew Palmer) |
ID Code: | 75180 |
Year Published: | 2011 |
Web of Science® Times Cited: | 16 |
Deposited By: | Menzies Institute for Medical Research |
Deposited On: | 2012-01-17 |
Last Modified: | 2017-11-02 |
Downloads: | 0 |
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