Objective: Recent trials have shown that Empagliflozin and Albiglutide can both reduce the risk of cardiovascular death and complications. It is unclear which one can produce higher clinical benefits and is more cost-effective. The study aimed to compare the cost-effectiveness of empagliflozin versus albiglutide among individuals with type 2 diabetes (T2D) in the US.

Method: A one-year tree-based cost-effectiveness model of cardiovascular death, hospitalization for heart failure, nonfatal myocardial infarction, and nonfatal stroke in individuals with T2D were developed from a US payer perspective. Complication risks for empagliflozin were extracted from the EMPA-REG trial. Complication risks for albiglutide were estimated using results from a meta-analysis that reported the relative risks of complications between empagliflozin and albiglutide. Direct medical cost inputs with an inflation rate of 3% and utilities were taken from published literature. Cost-effectiveness was determined using $50,000 willingness to pay per QALY. Sensitivity analyses were performed accordingly.

Result: Compared with albiglutide, the use of empagliflozin was associated with risk reductions in cardiovascular death (-33%) and hospitalization for heart failure (-8%), but risk increase in nonfatal myocardial infarction (+16%), and nonfatal stroke (+37%). The use of empagliflozin was associated with a higher cost (+$486) but also a higher QALY (0.013) in one year. The incremental cost-effectiveness ratio (ICER) is $ 37,721/QALY, suggesting a favorable economic value for empagliflozin over albiglutide. Results from sensitivity analysis show that our results are robust to parameter uncertainties.

Conclusion: Empagliflozin is cost-effective compared to albiglutide from the US payer perspective.