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Pharmacoeconomics. 2016 Sep;34(9):953-66. doi: 10.1007/s40273-016-0433-9.

Cost Effectiveness of IDegLira vs. Alternative Basal Insulin Intensification Therapies in Patients with Type 2 Diabetes Mellitus Uncontrolled on Basal Insulin in a UK Setting.

Author information

1
Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK.
2
Novo Nordisk Ltd, 3 City Place, Beehive Ring Road, Gatwick, West Sussex, RH6 0PA, UK. dng@novonordisk.com.
3
Novo Nordisk Ltd, 3 City Place, Beehive Ring Road, Gatwick, West Sussex, RH6 0PA, UK.
4
IMS Health, London, UK.
5
Centre for Health Economics, Swansea University, Swansea, Wales, UK.

Abstract

OBJECTIVES:

Once-daily insulin degludec/liraglutide (IDegLira) is the first basal insulin and glucagon like peptide-1 receptor agonist combined in one delivery device. Our aim was to investigate the cost effectiveness of IDegLira vs. basal insulin intensification therapies for patients with type 2 diabetes mellitus uncontrolled on basal insulin (glycosylated haemoglobin; HbA1c >7.5 %; 58 mmol/mol) in a UK setting.

RESEARCH DESIGN AND METHODS:

Baseline cohort and clinical parameters were sourced from a pooled analysis comparing IDegLira with basal insulin plus liraglutide and basal-bolus therapy, and from the DUAL™ V trial comparing IDegLira with up-titrated insulin glargine (IGlar; Lantus(®)). The CORE Diabetes Model simulated lifetime costs and outcomes with IDegLira vs. these comparators from a UK healthcare payers' perspective. All costs were expressed in 2015 GBP. Sensitivity analyses were performed to assess the impact of key parameters in the model.

RESULTS:

Treatment with IDegLira resulted in mean increases in quality-adjusted life-years (QALYs) of 0.12, 0.41 and 0.24 vs. basal insulin plus liraglutide, basal-bolus therapy and up-titrated IGlar, respectively. IDegLira was associated with lower costs of £971 and £1698 vs. basal insulin plus liraglutide and basal-bolus therapy, respectively, and increased costs of £1441 vs. up-titrated IGlar. IDegLira was dominant, i.e., both more effective and less costly vs. basal insulin plus liraglutide and basal-bolus therapy, and highly cost effective vs. up-titrated IGlar with an incremental cost-effectiveness ratio of £6090/QALY gained.

CONCLUSIONS:

Once-daily IDegLira may be considered a cost-effective treatment option for prescribers, to improve glycaemic control for type 2 diabetes patients uncontrolled on basal insulin without an increased risk of hypoglycaemia or weight gain, and without adding to their injection burden.

PMID:
27438706
DOI:
10.1007/s40273-016-0433-9
[Indexed for MEDLINE]

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