OBJECTIVES

To estimate the long-term cost-effectiveness of Vildagliptin vs sulfonylurea as add-on therapy to oral antidiabetic drugs(OADs) in patients with T2D M in China. Our analysis was performed from the perspective of healthcare payers.

METHODS

The Cardiff Diabetes Model was used to simulate disease progression and estimate the long-term effects of vildagliptin+metformin therapy relative to comparator sulfonylurea+ metformin therapy. Patient profiles and treatment effects required for the model were obtained from the study of Prospective Diabetes Study (PDS ) in China. Data from clinical practice will be recorded at baseline and will be prospectively documented during visits at 3, 6, 12 months and interim if available. There will be two pre-define cohorts, one is 666 patients with vildagliptin+metformin treatments and the other is 382 patients with sulfonylurea+metformin treatments. Medical expenditure data were collected from 639 patients with T2DM (aged≥18 years) with and without complications incurred between January 1, 2014 and December 31, 2015 from claims databases in Shandong, China. Costs (2014 Chinese Yuan [¥]) and benefits were estimated,from the payers’ perspective, over 40 years at a discount rate of 3%. A series of sensitivity analyses were performed.

RESULTS

: Patients on vildagliptin+metformin had a lower predicted incidence of most cardiovascular and hypoglycemic events. Vildagliptin had an ICER of ¥27490/QALY, lower than the willingness-to-pay threshold of ¥59261/QALY (per capita GDP of china, 2017), as second-line and as add-ons to metformin, in comparison to sulfonylureas.

CONCLUSIONS

: Patients with T2DM inadequately controlled by OADs in China. According to the WHO threshold applied to the country and year of the study, Vildagliptin is highly cost-effectiveness as second-line, as add-ons to metformin, in comparison with sulfonylureas. And It may address the problem of an excess of medical needs resulting from weight gain and hypoglycemia in T2DM treatment.