A LIFETIME COST-UTILITY ANALYSIS OF IGLARLIXI VERSUS IDEGASP IN TYPE 2 DIABETES IN TURKIYE
Author(s)
Elif Hilal Vural, MD1, Bulent Gumusel, PhD2, Cigdem Duran, BSc3, Secil Ileri, MD4, Kagan Atikeler, MSc5, Mafalda Ramos, MSc6, Mark Lamotte, MD6.
1School of Medicine, Department of Medical Pharmacology, Lokman Hekim University, Ankara, Turkey, 2Faculty of Pharmacy, Department of Pharmacology, Istanbul Okan University, Istanbul, Turkey, 3Sanofi Turkey, Istanbul, Turkey, 4Sanofi, Istanbul, Turkey, 5Market Access Lead/PhD Student, Sanofi Turkey, Istanbul, Turkey, 6Th(is)²Modeling, Asse, Belgium.
1School of Medicine, Department of Medical Pharmacology, Lokman Hekim University, Ankara, Turkey, 2Faculty of Pharmacy, Department of Pharmacology, Istanbul Okan University, Istanbul, Turkey, 3Sanofi Turkey, Istanbul, Turkey, 4Sanofi, Istanbul, Turkey, 5Market Access Lead/PhD Student, Sanofi Turkey, Istanbul, Turkey, 6Th(is)²Modeling, Asse, Belgium.
OBJECTIVES: Effective glycemic control in type 2 diabetes (T2D) is crucial to prevent micro- and macrovascular complications.iGlarLixi(insulin glargine/lixisenatide) is a fixed-ratio basal insulin/GLP-1 receptor agonist combination for adults with T2D inadequately controlled on oral therapy or basal insulin.In Turkiye, iGlarLixi is currently reimbursed only for patients with BMI ≥35 kg/m²,and its main competitor is a cheaper premix insulin (insulin degludec/aspart, iDegAsp).An indirect comparison in 2025 showed iGlarLixi achieves greater HbA₁c reduction and weight loss than iDegAsp.We assessed the cost-effectiveness of iGlarLixi versus iDegAsp given this new evidence and the Turkish reimbursement context
METHODS: A lifetime cost-utility analysis was conducted from the Turkish public payer perspective.Adults with T2D uncontrolled on oral drugs or basal insulin were modeled initiating either iGlarLixi or iDegAsp.The Metabo-Reno Cardiovascular Disease Model(MRCDM©) was used to predict outcomes over a 50-year horizon.Key efficacy inputs(glycemic and weight changes)came from an indirect treatment comparison and clinical trials.Outcomes included life expectancy,quality-adjusted life years(QALYs),complication incidence.A willingness to pay (WTP)threshold of 600,440TRY(a GDP)used.Scenario and sensitivity analyses tested result robustness
RESULTS: iGlarLixi improved lifetime health outcomes versus iDegAsp across BMI subgroups.At a baseline BMI ~30 kg/m², iGlarLixi led to ~0.23 additional life years and 0.19 QALYs gained per patient compared to iDegAsp.While drug costs were higher with iGlarLixi,the incremental cost (~TRY 80,000) was partly offset by fewer diabetes complications.The resulting incremental cost-effectiveness ratio was ~TRY 400,000 per QALY,well below Turkey’s willingness-to-pay threshold.Clinically, iGlarLixi was associated with slightly fewer cardiovascular and other complications than iDegAsp.Scenario analyses confirmed these findings:under varied assumptions,iGlarLixi remained cost-effective in all tested cases
CONCLUSIONS: iGlarLixi is a cost-effective option compared to iDegAsp for uncontrolled T2D in Turkiye,delivering additional life years and QALYs at an acceptable cost.Given the favorable cost-effectiveness of iGlarLixi in patients below the current BMI ≥35 reimbursement cutoff,policymakers could broaden their perspective in the reimbursement restrictions to enhance patient access to newer treatments
METHODS: A lifetime cost-utility analysis was conducted from the Turkish public payer perspective.Adults with T2D uncontrolled on oral drugs or basal insulin were modeled initiating either iGlarLixi or iDegAsp.The Metabo-Reno Cardiovascular Disease Model(MRCDM©) was used to predict outcomes over a 50-year horizon.Key efficacy inputs(glycemic and weight changes)came from an indirect treatment comparison and clinical trials.Outcomes included life expectancy,quality-adjusted life years(QALYs),complication incidence.A willingness to pay (WTP)threshold of 600,440TRY(a GDP)used.Scenario and sensitivity analyses tested result robustness
RESULTS: iGlarLixi improved lifetime health outcomes versus iDegAsp across BMI subgroups.At a baseline BMI ~30 kg/m², iGlarLixi led to ~0.23 additional life years and 0.19 QALYs gained per patient compared to iDegAsp.While drug costs were higher with iGlarLixi,the incremental cost (~TRY 80,000) was partly offset by fewer diabetes complications.The resulting incremental cost-effectiveness ratio was ~TRY 400,000 per QALY,well below Turkey’s willingness-to-pay threshold.Clinically, iGlarLixi was associated with slightly fewer cardiovascular and other complications than iDegAsp.Scenario analyses confirmed these findings:under varied assumptions,iGlarLixi remained cost-effective in all tested cases
CONCLUSIONS: iGlarLixi is a cost-effective option compared to iDegAsp for uncontrolled T2D in Turkiye,delivering additional life years and QALYs at an acceptable cost.Given the favorable cost-effectiveness of iGlarLixi in patients below the current BMI ≥35 reimbursement cutoff,policymakers could broaden their perspective in the reimbursement restrictions to enhance patient access to newer treatments
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE111
Topic
Economic Evaluation
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)