Raya, Pedro MezquitaBlasco, Francisco Javier AmpudiaHunt, BarnabyMartin, VirginiaThorsted, Brian LarsenBasse, AmauryPrice, Hermione2023-01-252023-01-252019-03-20http://hdl.handle.net/10668/13542To 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.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/IDegLiraSpaincostcost-effectivenessinsulinreal-world evidencetype 2 diabetesCost-Benefit AnalysisDiabetes ComplicationsDiabetes Mellitus, Type 2Drug CombinationsHumansHypoglycemic AgentsInsulin, Long-ActingLiraglutideRetrospective StudiesSpainresearch article30740861open access10.1111/dom.136601463-1326PMC6594226https://doi.org/10.1111/dom.13660https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594226/pdf