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Abstract
Objectives:
The present study aimed to compare the projected long-term clinical and cost implications associated with liraglutide, sitagliptin and glimepiride in patients with type 2 diabetes mellitus failing to achieve glycemic control on metformin monotherapy in France.
Methods:
Clinical input data for the modeling analysis were taken from two randomized, controlled trials (LIRA-DPP4 and LEAD-2). Long-term (patient lifetime) projections of clinical outcomes and direct costs (2013 Euros; €) were made using a validated computer simulation model of type 2 diabetes. Costs were taken from published France-specific sources. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed.
Results:
Liraglutide was associated with an increase in quality-adjusted life expectancy of 0.25 quality-adjusted life years (QALYs) and an increase in mean direct healthcare costs of €2558 per patient compared with sitagliptin. In the comparison with glimepiride, liraglutide was associated with an increase in quality-adjusted life expectancy of 0.23 QALYs and an increase in direct costs of €4695. Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio (ICER) of €10,275 per QALY gained vs sitagliptin and €20,709 per QALY gained vs glimepiride in France.
Conclusion:
Calculated ICERs for both comparisons fell below the commonly quoted willingness-to-pay threshold of €30,000 per QALY gained. Therefore, liraglutide is likely to be cost-effective vs sitagliptin and glimepiride from a healthcare payer perspective in France.
Transparency
Declaration of funding
The study was supported by funding from Novo Nordisk.
Declaration of financial/other relationships
RR has served as an advisor or consultant for AstraZeneca, Lilly; Boehringer Ingelheinm; Janssen; MSD; Novo Nordisk; Sanofi; Abbvie; Novartis; Roche. LM has served as an advisor or consultant for Amgen Inc.; AstraZeneca Pharmaceuticals LP; GlaxoSmithKline; Ipsen; Lilly; Mayoly Spindler; Menarini; Novo Nordisk; Pfizer Inc; Abbvie; Novartis; Roche. BH and WV are employees of Ossian Health Economics and Communications, which received a consulting fee from Novo Nordisk to support the study. TV, HD, PE, and MG are employees of Novo Nordisk.
