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Abstract
Background
Glucagon-like peptide-1 (GLP-1) receptor agonists are indicated for improvement of glycemic control in adults with type 2 diabetes. Cost is one aspect of treatment to be considered, in addition to clinical benefits, when selecting optimal therapy for a patient. The objective of this study was to estimate the average dose usage and real world daily cost of the GLP-1 receptor agonists, exenatide twice daily and liraglutide once daily, in Germany, the Netherlands, and the UK.
Methods
Administrative databases were used to source the data from longitudinal records of dispensed prescriptions. Data were extracted from the IMS Longitudinal Prescription database which captures details of prescriptions dispensed in pharmacies. Information on the dispensed quantity of each product was used to estimate average daily usage per patient. Daily dose usage was multiplied by the public price per unit to estimate daily cost.
Results
The dispensed volume in Germany corresponded to a mean dispensed daily dose of 16.81 μg for exenatide twice daily and 1.37 mg for liraglutide (mean daily cost €4.02 and €4.54, respectively). In the Netherlands, average dispensed daily doses of 17.07 μg and 1.49 mg were observed for exenatide twice daily and liraglutide (mean daily cost €3.05 and €3.97, respectively). In the UK, the mean dispensed volume corresponded to a daily usage of 20.49 μg for exenatide twice daily and 1.50 mg for liraglutide (mean daily cost £2.53 and £3.28, respectively).
Conclusion
Estimates of average daily dispensed doses of GLP-1 receptor agonists derived from pharmacy data in real world settings corresponded to the dosing recommendation of the summaries of product characteristics. Nevertheless, the mean daily cost of exenatide twice daily was lower than that of liraglutide in Germany, the Netherlands, and the UK. Such estimates can be used to inform health care decision-makers on the real world usage and cost of medications effective in achieving glycemic control in patients with type 2 diabetes.
Acknowledgments
The authors thank Mary Beth DeYoung of AstraZeneca for critical review and useful editorial suggestions.
Disclosure
This research was conducted by IMS Health with sponsorship by Eli Lilly and Company. This article was prepared by IMS Health with guidance from Eli Lilly and Company and reviewed by AstraZeneca. AstraZeneca provided funding for editorial revisions of this manuscript by inScience late in its development. Amanda L McDonell, Robert W Kotchie, and Thomas Haslam are employed by IMS Health. Per-Olof Thuresson, Michiel Bruinsma, and Danielle C Zammit were employed by IMS Health at the time of the study. Thorsten Otto is employed by Eli Lilly and Company, Germany. Urpo Kiiskinen and Claudia Nicolay are employed by and are stock shareholders of Eli Lilly and Company, Germany. Anne-Jeanine Janszen-Van Oosterhout was employed by and was a stock shareholder of Eli Lilly Nederland, the Netherlands, at the time of the study. The authors report no other conflicts of interest in this work.