Cost-Effectiveness Analysis of iGlarLixi Compared With Basal Bolus Insulin Regimen in Triple Metabolic Goal in Type 2 Diabetes Mellitus in Latin America

OBJECTIVES: iGlarLixi has shown to be effective in decreasing Hb1AC, with a neutral effect on body weight, and no increased risk of hypoglycemic events (Triple Metabolic Goal [TMG]) in adults with type 2 diabetes (T2DM). This study aims to calculate the achievement of the composite endpoints (CE) costs with iGlarLixi compared to Basal-Bolus (rapid-acting insulin plus Gla-U100 [B/B]) in 5 Latin-American countries: Panama, Costa Rica, Salvador, Guatemala, and Honduras.

METHODS: A cost-effectiveness analysis was done to determine the CE achievement costs in T2DM adults in one-year considering the proportion of patients that achieve the TMG.

The cost-effectiveness index (CEI) was calculated as the quotient between the cost per patient achieving the CE with B/B and iGlarLixi.

RESULTS: The proportion of patients achieving the TMG for iGlarLixi and B/B were 26.8% and 12.4% respectively, indicating an efficacy index of 2.16. On average, the total annual cost of iGlarLixi treatment was USD$2,142 (USD$1,819-USD$2,668) vs USD$1,569 (USD$1,314-USD$1,790) for B/B, representing a difference of 36% (31%-49%). However, the cost per patient achieving the TMG with iGlarLixi was lower compared to B/B: USD$7,994 (USD$6,786-USD$9,954) vs USD$12,655 (USD$11,830-USD$14,433), respectively, equivalent to a 37% (31%-39%) lower cost favoring iGlarLixi.

The average CEI was 1.59, with Honduras and Costa Rica exhibiting the highest index (1.65), followed by Panama (1.64), Salvador (1.56) and finally Guatemala (1.45). The larger the difference for treatment cost, the lower the CEI observed as can be seen for Guatemala with B/B having 49% lower treatment costs than iGlarLixi and having the lowest CEI.

CONCLUSIONS: iGlarLixi has a lower cost per patient reaching the TMG compared to B/B. The study suggests that per each USD$1 invested in iGlarLixi to reach the TMG, it is necessary to invest, on average, USD$1,59 in B/B treatment to obtain the same therapeutic results in the different Latin-American countries included in this analysis.