Published in:
Open Access 01-08-2017 | Original Research
Modeling the Long-Term Cost-Effectiveness of IDegLira in Patients with Type 2 Diabetes Who are Failing To Meet Glycemic Targets on Basal Insulin Alone in The Netherlands
Published in: Diabetes Therapy | Issue 4/2017
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Introduction
Insulin degludec/liraglutide (IDegLira) is the first basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) in a single pen injection device, and a once-daily treatment option for patients with type 2 diabetes mellitus (T2DM) who are uncontrolled on basal insulin and require treatment intensification. The objective of this analysis was to evaluate the long-term cost-effectiveness of IDegLira versus basal-bolus therapy (insulin glargine U100 + 3× daily insulin aspart) for patients with T2DM uncontrolled on basal insulin [HbA1c >53 mmol/mol (>7%)] in the Netherlands.
Methods
Cost-effectiveness analysis was performed using the validated IMS CORE Diabetes Model from a healthcare payer perspective. Outcomes were modeled over patient lifetimes in a cohort with baseline characteristics from the DUAL™ II trial. Treatment effect data were sourced from a statistical indirect comparison (pooled analysis) of IDegLira with basal-bolus therapy.
Results
Treatment with IDegLira resulted in mean increases in quality-adjusted life expectancy of 0.43 quality-adjusted life years versus basal-bolus therapy. Improved clinical outcomes resulted from fewer diabetes-related complications and a delayed time to their onset. IDegLira was associated with lower costs of EUR 4679 versus basal-bolus therapy, a result of lower pharmacy costs and avoided diabetes-related complications. Thus, IDegLira was dominant, i.e., both more effective and less costly than basal-bolus therapy.
Conclusions
IDegLira is an effective treatment option to improve glycemic control without incurring an increased risk of hypoglycemia or weight gain. This analysis suggests that IDegLira is cost-effective versus basal-bolus therapy in patients with T2DM who are uncontrolled on basal insulin in the Netherlands.
Funding
Novo Nordisk.