Publication: Evaluating the long-term cost-effectiveness of fixed-ratio combination insulin degludec/liraglutide (IDegLira) for type 2 diabetes in Spain based on real-world clinical evidence.
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Identifiers
Date
2019-03-20
Authors
Raya, Pedro Mezquita
Blasco, Francisco Javier Ampudia
Hunt, Barnaby
Martin, Virginia
Thorsted, Brian Larsen
Basse, Amaury
Price, Hermione
Advisors
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Abstract
To evaluate the long-term cost-effectiveness of fixed-ratio combination insulin degludec/liraglutide (IDegLira) versus comparator regimens for type 2 diabetes in Spain, based on real-world evidence. Clinical data were taken from the European Xultophy Treatment Retrospective Audit (EXTRA) real-world evidence study in which patients failing to meet glycaemic targets were switched to IDegLira. Baseline regimens (prior to IDegLira treatment) were categorized as: multiple daily insulin injections (MDI; 28%); glucagon-like peptide-1 (GLP-1) receptor agonists in combination with insulin (24%); basal insulin (19%); GLP-1 receptor agonists (10%); and non-injectable medications (19%). The IQVIA CORE Diabetes Model was used to project long-term outcomes for patients switching to IDegLira or continuing their baseline regimens (excluding non-injectable regimens). Costs were accounted from a Spanish National Health System perspective. Future costs and clinical benefits were discounted at 3% annually and sensitivity analyses were performed. IDegLira was projected to reduce the incidence of diabetes-related complications and improve quality-adjusted life expectancy versus all four comparators. IDegLira reduced direct medical costs versus GLP-1 receptor agonists in combination with insulin, and versus GLP-1 receptor agonist therapy, and was therefore considered dominant (cost saving while improving outcomes). IDegLira was found to be cost-effective versus MDI and basal insulin with incremental cost-effectiveness ratios of EUR 3013 per quality-adjusted life-year (QALY) gained and EUR 6890 per QALY gained, respectively. Long-term projections based on real-world evidence indicated that IDegLira is likely to improve clinical outcomes and reduce costs or be cost-effective compared with other injectable regimens in people with type 2 diabetes in Spain.
Description
MeSH Terms
Cost-Benefit Analysis
Diabetes Complications
Diabetes Mellitus, Type 2
Drug Combinations
Humans
Hypoglycemic Agents
Insulin, Long-Acting
Liraglutide
Retrospective Studies
Spain
Diabetes Complications
Diabetes Mellitus, Type 2
Drug Combinations
Humans
Hypoglycemic Agents
Insulin, Long-Acting
Liraglutide
Retrospective Studies
Spain
DeCS Terms
CIE Terms
Keywords
IDegLira, Spain, cost, cost-effectiveness, insulin, real-world evidence, type 2 diabetes