Cost-effectiveness of vildagliptin for people with type 2 diabetes mellitus in Brazil; findings and implications

ABSTRACT

Introduction: Vildagliptin is an inhibitor of the enzyme dipeptidyl peptidase 4, indicated for the treatment of type 2 diabetes mellitus, combined or not with metformin. This study aims to evaluate the cost-effectiveness of vildagliptin in the Brazilian context.

Areas covered: Using MEDLINE, Cochrane Library, Lilacs and CRD, six studies were selected for the economic models. This study utilised cost data in the Brazilian health system to provide the context.

Expert commentary: Type 2 diabetes mellitus is an epidemic disease and represents a challenge for all health care systems. Although guidelines clearly define first-line treatment, there are several other promising treatments. Vildagliptin is one of them, resulting in a mean lifetime increase of 0.31 years compared to metformin alone and 1.19 more life years compared to other metformin combinations. Considering observational data, life years with dual vildagliptin-containing treatments were 0.37 more compared to other dual treatments. However, its high cost versus generic metformin and its unclear safety profile weakens its subsequent cost-effectiveness. Consequently, the incorporation of vildagliptin or its combination with metformin is currently not recommended for the Brazilian Health Care System. This may change as more data becomes available.

KEYWORDS:

• Vildagliptin
• cost-effectiveness
• Brazil
• type 2 diabetes
• metformin

Acknowledgments

The research was supported by the Research Group in Pharmacoepidemiology of the Federal University of Minas Gerais (UFMG).

Declaration of interest

Gustavo Laine Araujo de Oliveira received a scholarship from the Brazilian Federal Agency for the Support and Evaluation of Graduate Education (Capes). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This work was funded by National Council for Scientific and Technological Development (CNPq) and the Foundation for Research Support of the State of Minas Gerais (FAPEMIG). The write-up was in part supported by a Newton Advanced Fellowship awarded to Professor Augusto Afonso Guerra Junior by the Academy of Medical Sciences, through the UK Government’s Newton Fund program.