Cost-effectiveness of saxagliptin vs glimepiride as a second-line therapy added to metformin in Type 2 diabetes in China

Abstract

Objective:

This study aims to estimate the long-term cost-effectiveness of saxagliptin + metformin (SAXA + MET) vs glimepiride + metformin (GLI + MET) in patients with Type 2 diabetes mellitus (T2DM) inadequately controlled with MET in China.

Methods:

The Cardiff Model was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews and hospital surveys were conducted to obtain patients profiles, clinical data, and costs. Health insurance costs (2014¥) were estimated over a 40-year period. One-way and probabilistic sensitivity analyses were performed.

Results:

SAXA + MET had lower predicted incidences of cardiovascular and hypoglycemia events and a decreased total cost compared with GLI + MET (¥241,072,807 vs ¥285,455,177). There were increased numbers of quality-adjusted life-years (QALYs; 1.01/patient) and life-years (Lys; 0.03/patient) gained with SAXA + MET compared with GLI + MET, and the incremental cost of SAXA + MET vs GLI + MET (−¥44,382) resulted in −¥43,883/QALY and −¥1,710,926/LY gained with SAXA + MET. Sensitivity analyses confirmed that the results were robust.

Conclusion:

In patients with T2DM in China, SAXA + MET was more cost-effective and was well tolerated with fewer adverse effects (AEs) compared with GLI + MET. As a second-line therapy for T2DM, SAXA may address some of the unmet medical needs attributable to AEs in the treatment of T2DM.

Keywords::

• Cost-effectiveness
• Saxagliptin
• Sulfonylurea
• Glimepiride
• Type 2 diabetes
• China
• Cardiff model

Transparency

Declaration of funding

This study was sponsored by AstraZeneca.

Declaration of financial/other relationships

SG, JD, LS, YM, and HD have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

Acknowledgments

The authors thank Xuemei Zhen and Yuhang Zeng (Zhejiang University School of Public Health, Hangzhou, China) for their help in collecting data.