OBJECTIVES

The objective of this study was to undertake a long-term cost-effectiveness analysis of dapagliflozin, a sodium-glucose co-transporter-2 (SGLT-2) inhibitor, compared with sulfonylurea (SU), when added to metformin, in Vietnamese Type 2 diabetes mellitus (T2DM) patients inadequately controlled on metformin monotherapy.

METHODS

The economic analysis using the Cardiff diabetes decision model considered the overall DECLARE trial population. The DECLARE risk equations were developed for the incidence of myocardial infarction (MI), ischaemic stroke, hospitalisation for heart failure (HHF), hospitalisation for unstable angina pectoris (HAP), non-coronary revascularisation, percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), amputation, cardiovascular (CV) death and non-CV death. Economic and utility data used in the model were sourced from publications in Vietnam. The direct acquisition costs of the individual treatments, as well as the costs incurred for management of T2DM-related events, chronic kidney disease (CKD), and associated adverse events were identified for both arms. Indirect costs for diabetes and diabetes-related events were also included. Sensitivity analyses were conducted to assess the impact of uncertainty on the final model results.

RESULTS

Compared with SU + metformin, the cost per quality-adjusted life year (QALY) gained with dapagliflozin + metformin was $2,246 in Vietnam. Dapagliflozin + metformin was associated with incremental QALY of 0.46 [95% confidence interval (CI): 0.449; 0.464] and incremental cost of $1,033 [95% CI: $995; $1,071]. Results were robust across both one-way and probabilistic sensitivity analyses. Probabilistic sensitivity analysis determined that dapagliflozin had a 100% probability of being cost-effective at a willingness-to-pay threshold of three times GDP per capita per QALY ($8,100)

CONCLUSIONS

As compared to SU, dapagliflozin is a cost-effective treatment in combination with metformin for Vietnamese T2DM patients from a societal perspective.