OBJECTIVES : To evaluate the long-term cost-effectiveness of liraglutide compared with insulin glargine in patients with type 2 diabetes mellitus (T2DM) insufficiently controlled on metformin monotherapy from China’s health care system perspective.

METHODS : The published and validated Swedish Institute for Health Economics Cohort Model was used to project health and economic outcomes for patients with T2DM treated with liraglutide or insulin glargine over a 30-year horizon. Simulated cohort data and treatment effects were obtained from a 26-week, open-label, randomized, controlled clinical research comparing liraglutide 1.2mg once daily with insulin glargine, both as add-on to metformin, for T2DM patients insufficiently controlled on metformin. Treatment costs of diabetes-related complications were retrieved from published sources in China. Cost data reflected year 2020 price level. A 5% discount rate was applied to both costs and health outcomes. One-way and probabilistic sensitivity analyses was performed.

RESULTS : Liraglutide was associated with improved discounted life years of 0.143 (12.217 vs. 12.074) and quality-adjusted life years (QALYs) of 0.743 (7.263 vs. 6.519) compared with insulin glargine. Improvements were mostly driven by benefits in glycemic control, leading to a reduced incidence of diabetes-related complications (e.g., background retinopathy -2.49%, macroalbuminuria -2.52%, microalbuminuria -1.13%, ischemic heart disease -2.31%, myocardial infarction -3.27%, stoke -2.16%, and heart failure -5.08%) in liraglutide group. Liraglutide was associated with reduced lifetime costs of CNY 10,477 versus glargine (CNY 364,128 vs. CNY 374,605), which was mainly derived from lower treatment cost of macrovascular complications (CNY -6,837, CNY 71,324 vs. CNY 78,162), microvascular complications (CNY -3,617, CNY 143,473 vs. CNY 147,091) and hypoglycemia (CNY -1,138, CNY 193 vs. 1,331). Liraglutide is a dominant option over insulin glargine. Sensitivity analyses confirmed the robustness of the model.

CONCLUSIONS : Liraglutide is estimated to be a cost saving treatment in China compared with insulin glargine for patients with T2DM insufficiently controlled on metformin.