| The Cost-Effectiveness of Saxagliptin Versus NPH Insulin When Used in Combination with Other Oral Antidiabetes Agents in the Treatment of Type 2 Diabetes Mellitus in Poland. | |
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MedLine Citation:
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PMID: 22066527 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract Background: This study compared the health and economic benefits of saxagliptin versus insulin as second-line therapy with either metformin (MET) or sulfonylurea (SU) after failure of the respective monotherapies for patients with type 2 diabetes in Poland. Methods: The cost-effectiveness was assessed using a previously published diabetes model. Disease progression, utilities, and effects of changes in glycosylated hemoglobin (HbA1c), weight, and hypoglycemic events were taken from published studies, and Polish sources were used where possible. Results: MET + saxagliptin reduced severe hypoglycemic complications and weight versus MET + insulin, with an incremental benefit of 0.13 quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER) of 27,454 Polish zloty (PLN) ($9,966 U.S.) per QALY gained. SU + saxagliptin showed an incremental benefit of 0.14 QALYs and ICER of 24,663 PLN ($8,953 U.S.) per QALY gained versus SU + insulin, with reduced incidence of symptomatic and severe hypoglycemias. Results were most sensitive to disutilities associated with weight gain, hypoglycemia, injection fear, HbA1c changes, threshold for switching treatment, and patients' age. Results were robust to various model assumptions and inputs. Using a willingness-to-pay threshold of 100,000 PLN ($36,300 U.S.) per QALY gained, the probability that saxagliptin is cost-effective in these analyses was 74% (MET) and 76% (SU). Conclusions: Saxagliptin in combination with MET or SU is likely to represent a cost-effective treatment option in Polish patients with type 2 diabetes failing first-line treatment. |
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Authors:
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Wladyslaw Grzeszczak; Leszek Czupryniak; Katarzyna Kolasa; Cezary Sciborski; Isabelle Duprat Lomon; Phil McEwan |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-8 |
Journal Detail:
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Title: Diabetes technology & therapeutics Volume: - ISSN: 1557-8593 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100889084 Medline TA: Diabetes Technol Ther Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1 Diabetological Unit, Department of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia , Zabrze, Poland . |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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