COST-EFFECTIVENESS ANALYSIS OF METFORMIN COMBINED WITH SAXAGLIPTIN VERSUS METFORMIN COMBINED WITH SULFONYLUREAS IN TYPE-2 DIABETES PATIENTS IN CHILE

ELGART J; CAPORALE J; AIELLO E; GAGLIARDINO JJ; WASCHBUSCH M; JOTIMLIANSKY L; VALENCIA J

Congreso; 16th Annual International Meeting ISPOR; 2011

ISPOR

Objectives: To determine the cost-effectiveness relation of adding Saxagliptin to Metformin therapy (SAXA+MET) compared to adding Sulfonylureas (SULF+MET), in patients with type 2 diabetes mellitus (DM2) who have failed to achieve adequate glycemic control with metformin. Methods: A discrete event simulation model (Cardiff long term cost-utility model) with a fixed time increase based on UKPDS 68 was used to simulate disease progression and to obtain an estimate of the treatment's economic and health consequences in DM2 patients. Clinical efficacy parameters for Saxagliptin were obtained from the literature; drug acquisition costs, adverse events (AEs) and microvascular and macrovascular complications were taken into account. The time horizon was 20 years and the perspective was that of the public health care system in Chile. Costs were expressed in US dollars (2009), with an annual 3.5% discount. Results: A lower number of non-fatal events were found for the SAXA+MET-treated group versus the SULF+MET-treated group. Additionally, the model predicted a lower number of fatal macrovascular (132.3 vs. 136.0) and microvascular (19.6 vs. 19.7) events for the SAXA+MET-treated group vs. the SULF+MET-treated group. The total cost of the SAXA+MET cohort was lower than the SULF+MET cohort: US$ 15.006.011 and U$S 14.557.581, respectively. Treatment with SAXA+MET resulted in a higher number of QALYs (9,794 vs. 9,594) and LYs (23,068 vs. 23,019) for the 1000 patients' cohort than treatment with SULF+MET; the incremental analysis per QALY and LY gained was -US$2,243 and US$ −9,182 respectively (dominant). Conclusions: Results suggest that the addition of Saxagliptin to metformin therapy is dominant compared to the addition of sulfonylureas; therefore, this intervention would represent an efficient use of health resources for DM2 patients in Chile.