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Health Economics Review
Published in: Health Economics Review 1/2013

Open Access 01-12-2013 | Research

Treatment of type 2 diabetes with saxagliptin: a pharmacoeconomic evaluation in Argentina

Authors: Jorge F Elgart, Joaquin E Caporale, Lorena Gonzalez, Eleonora Aiello, Maximiliano Waschbusch, Juan J Gagliardino

Published in: Health Economics Review | Issue 1/2013

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Abstract

Background

The increasing prevalence of diabetes and its inadequate management results in a heavy burden of the disease for the patients, the health and the productive system and the overall community. Consequently, it is necessary to have new effective drugs to treat people with diabetes to decrease such burden. DPP-4 inhibitors can help to cope with this demand, but its usage is challenged by its apparent high cost. The aim of the current study was to compare a simulated cost-effectiveness ratio of metformin (MET) plus one drug of the DPP-4 inhibitors family, saxagliptin (SAXA) or sulfonylurea (SU) treatment during a 20-year period, from the perspective of the social security system, in a cohort of people with Type 2 diabetes (T2DM) who did not attain glycosylated hemoglobin treatment target values only with MET.

Methods

A discrete event simulation model (Cardiff diabetes model) based on UKPDS 68 was used to simulate disease progression and to estimate the economic and health treatment consequences in people with T2DM. The clinical efficacy parameters for SAXA administration were obtained from the literature; local standard costs were considered for drug acquisition, adverse events (AEs), and micro/macrovascular complications. Costs were expressed in US dollars (2009) with an annual 3.5% discount and a 20-year time horizon.

Results

The SAXA + MET treated group had a lower number of non-fatal events than the SU + MET treated group. The model also predicted a lower number of fatal macrovascular events for the SAXA + MET group (149.6 vs. 152.8). The total cost of the SAXA + MET cohort was 15% higher than that of the SU + MET cohort. Treatment with SAXA + MET resulted in a higher number of quality-adjusted life years (QALYs) (9.54 vs. 9.32) and life-years gained (LYGs) (20.84 vs. 20.76) compared to those treated with SU + MET. The incremental cost per QALY and LYG gained was $7,374 and $20,490, respectively.

Conclusions

According to the criteria proposed by the Commission on Macroeconomics and Health, the use of the combination SAXA + MET is highly cost-effective in Argentina.
Appendix
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Metadata
Title
Treatment of type 2 diabetes with saxagliptin: a pharmacoeconomic evaluation in Argentina
Authors
Jorge F Elgart
Joaquin E Caporale
Lorena Gonzalez
Eleonora Aiello
Maximiliano Waschbusch
Juan J Gagliardino
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
Health Economics Review / Issue 1/2013
Electronic ISSN: 2191-1991
DOI
https://doi.org/10.1186/2191-1991-3-11

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