INTRODUCTION: The objective of this study is to estimate the budgetary impact of the adoption of lixisenatide in combination with insulin glargine (iGlarLixi) for the treatment of type II diabetes mellitus from the perspective of the Guatemalan Social Security Institute (IGSS).

METHODS: The budget impact analysis was conducted over a 5-year horizon by adapting an analytical model developed in Excel. Based on epidemiological projections and information on antidiabetic use, a target population of 4,352 patients was estimated, corresponding to those patients who do not obtain adequate control with two or more oral antidiabetics or basal insulin. The current scenario was compared to one in which iGlargLixi begins to capture 5% of the market from the second year and increases by 5 percentage points per year. For the baseline scenario, acquisition, monitoring and adverse event costs were included and an additional scenario with costs for micro- and macrovascular complications was considered. Clinical effectiveness was obtained from medical literature and costs were estimated from local and tariff databases.

RESULTS: The base case shows that the adoption of iGlarLixi for the treatment of type II diabetes mellitus in Guatemala will require a budgetary effort of Q13.9 million (+8%) after 5 years, which corresponds to an increase of 8%. When including the costs of micro- and macrovascular complications, the inclusion of the drug would represent a saving of Q7.1 million (-0.7%) after 5 years for the IGSS.

CONCLUSIONS: iGlarLixi represents higher acquisition costs than other currently available antidiabetics, but considering the health benefits, its inclusion in the IGSS for the treatment of type II diabetes mellitus would represent a budget saving.