OBJECTIVES: In 2018’s ADA/EASD recommendations, metformin is the preferred initial treatment for T2D patients, but in those who need the greater glucose-lowering effect of an injectable medication, GLP-1 receptor agonists are the preferred choice to insulin. In Algeria, although liraglutide is the unique in class to be authorized, it is still not reimbursed by payers anticipating high budget impact. This study evaluated associated savings with once daily liraglutide 1,2 mg versus insulin in Algerian T2D patients insufficiently controlled under oral medications.

METHODS: Data were taken from the Barometer “Changing Diabetes” real world observational study performed in Algeria (N = 14.609 T2D patients), aiming to generate care performance indicators. In addition, a meta-analysis of liraglutide clinical trial program (seven trials, N = 4.625) on 26-week patient-level data evaluating the proportion of patients achieving a clinically relevant composite outcome (HbA1c <7% without weight gain or hypoglycaemia) versus commonly used therapies for T2D was also exploited.

RESULTS: Liraglutide 1,2mg was associated with increased direct costs (150.380 DZD/patient/year) versus glargine insulin (89.790 DZD), but percentage of patients reaching composite end point was higher (32% versus 15%). Liraglutide 1,2mg is projected to be cost-saving (469.938 DZD/patient reaching the end point versus 598.600 DZD). Besides that, 78,9% of patients under insulin basal regimen require intensification, and basal-bolus is the most used regimen (57%), inducing higher direct costs (from 194.400 DZD), followed by premix BID regimen (43% of occurrence with costs starting from 114.000 DZD). Additively, 78,5% of T2D patients were overweight, and 81,9% uncontrolled with insulin treatment that also put them at risk for hypoglycaemic events and developing costly complications. As result of delaying initiation of insulin treatment, liraglutide allows savings from 546 million DZD to 1,28 billion DZD (40.000 DZD/patient/year).

CONCLUSIONS: Liraglutide 1,2mg is likely to be cost-saving from healthcare payers perspective in Algeria.