Modeling the Clinical and Economic Impact of DPP-4 Inhibitors in Uncontrolled T2D
Author(s)
Nikolay Avksentyev, MA1, Aleksandr Makarov, BSc, MSc2.
1Financial Research Institute, Moscow, Russia; Pharmaceutical Analytics, US; Health and Market Access Consulting, Moscow, Russian Federation, 2Health and Market Access Consulting, Moscow, Russia; Pharmaceutical Analytics Middle East, Ras al Khaimah, United Arab Emirates.
1Financial Research Institute, Moscow, Russia; Pharmaceutical Analytics, US; Health and Market Access Consulting, Moscow, Russian Federation, 2Health and Market Access Consulting, Moscow, Russia; Pharmaceutical Analytics Middle East, Ras al Khaimah, United Arab Emirates.
Presentation Documents
OBJECTIVES: Type 2 diabetes (T2D) remains a major contributor to population mortality, driven by poor glycemic control and cardiovascular complications. Achieving glycated hemoglobin (HbA1c) levels below 7.0% is a widely recognized target in diabetes management, yet many patients on metformin (MET) and/or sulfonylureas (SU) therapy fail to reach this goal. This study assesses the clinical and economic impact of expanding the use of dipeptidyl-peptidase 4 (DPP-4) inhibitors in patients with uncontrolled T2D despite current oral therapy.
METHODS: A mathematical model was developed to evaluate two scenarios over a 5-year horizon: continuation of current treatment patterns versus adding a DPP-4 inhibitor in eligible patients. The target population included Russian adults with T2D and HbA1c between 7.1% and 9.0% receiving MET and/or SU without significant comorbidities, or MET + SGLT2 inhibitors (irrespective of comorbidities). For modeling purposes, equivalent efficacy across the DPP-4 inhibitor class was assumed. HbA1c level reduction rate was based on clinical trial data, and patient distribution across HbA1c levels was derived from a diabetes registry. Mortality risk was linked to HbA1c levels using published hazard ratios.
RESULTS: Among an estimated 777,857 eligible patients, adding a DPP-4 inhibitor to existing regimens increased the proportion of patients achieving HbA1c <7.0% from 44.8% to 53.7%. Over five years, an estimated 9,740 deaths could be prevented. The incremental annual cost of implementing DPP-4 inhibitors across the entire eligible population was projected at USD 105 million. Based on modeled mortality outcomes, the estimated cost per life saved was USD 53,928. While direct drug expenditures increased with introduction of DDP-4 inhibitor, these could be partly offset by the potential long-term benefits of reduced disease progression and fewer diabetes-related complications.
CONCLUSIONS: Expanding access to DPP-4 inhibitors for patients with uncontrolled T2D can substantially increase the share of patients reaching glycemic targets and prevent premature deaths.
METHODS: A mathematical model was developed to evaluate two scenarios over a 5-year horizon: continuation of current treatment patterns versus adding a DPP-4 inhibitor in eligible patients. The target population included Russian adults with T2D and HbA1c between 7.1% and 9.0% receiving MET and/or SU without significant comorbidities, or MET + SGLT2 inhibitors (irrespective of comorbidities). For modeling purposes, equivalent efficacy across the DPP-4 inhibitor class was assumed. HbA1c level reduction rate was based on clinical trial data, and patient distribution across HbA1c levels was derived from a diabetes registry. Mortality risk was linked to HbA1c levels using published hazard ratios.
RESULTS: Among an estimated 777,857 eligible patients, adding a DPP-4 inhibitor to existing regimens increased the proportion of patients achieving HbA1c <7.0% from 44.8% to 53.7%. Over five years, an estimated 9,740 deaths could be prevented. The incremental annual cost of implementing DPP-4 inhibitors across the entire eligible population was projected at USD 105 million. Based on modeled mortality outcomes, the estimated cost per life saved was USD 53,928. While direct drug expenditures increased with introduction of DDP-4 inhibitor, these could be partly offset by the potential long-term benefits of reduced disease progression and fewer diabetes-related complications.
CONCLUSIONS: Expanding access to DPP-4 inhibitors for patients with uncontrolled T2D can substantially increase the share of patients reaching glycemic targets and prevent premature deaths.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE585
Topic
Clinical Outcomes, Economic Evaluation, Health Technology Assessment
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)