Treatment of type 2 diabetes in Colombia: economic evaluation of Saxagliptin/Metformin extended-release (xr) fixed-dose combination (FDC).

ELGART JORGE; PRESTES MARIANA; GONZALEZ LORENA; GARRIDO LECCA S; AIELLO ELEONORA; JIMENEZ C

Congreso; ISPOR 19th International Meeting, Montreal, Canadá. Value in Health. 2014; 2014

OBJECTIVES: To evaluate the economic impact of using saxagliptin/metformin XR FDC versus sulfonylurea(SU) plus metformin (MET) in Colombia, in people with type 2 diabetes (T2DM) who do not achieve treatment goal 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. Epidemiologic and clinical efficacy parameters were obtained from the literature. Cost of medication was obtained from country level drug prices, SISMED and Farmaprecios; cost of macro and microvascular events were based on POS tariffs, SOAT Manual and consultation with a local expert. A 20-year time horizon was assumed. Costs and health outcomes were discounted at 3% annually. Deterministic and probabilistic sensitivity analysis were also performed. RESULTS: The group treated with saxagliptin/metformin XR had fewer non-fatal events and episodes of hypoglycemia than the SU plus MET treated group. The model also predicted a lower number of fatal macrovascular events for the saxagliptin/metformin XR group (159 vs. 162). In both treatment groups the costs were driven by drug and treatment costs associated with myocardial infarction. The total cost of saxagliptin/metformin XR group over 20 years was lower than SU plus MET treated group (US$ 14,454,257 vs. US$ 14,735,176). Treatment with saxagliptin/metformin XR resulted in a greater number of quality-adjusted life years (QALYs) and life-years gained (LYG) than the SU combination (10,203 vs. 9,955 and 12,207 vs. 12,190 respectively). Cost-effectiveness results were robust according to sensitivity analysis. CONCLUSIONS: according to the model cost-effectiveness results in Colombia, saxagliptin/metformin XR FDC would be the dominant treatment option compared to SU as add-on to MET, for people with T2DM after failure of treatment only with MET.