OBJECTIVES: This research evaluates the cost-effectiveness of the fixed-dose combination of Dapagliflozin and Metformin (Xigduo) versus Dapagliflozin monotherapy and free-dose combination with Dapagliflozin and Metformin for managing T2DM in Chinese patients, specifically those for whom traditional lifestyle interventions such as dietary changes and increased physical activity have failed to adequately control blood glucose levels.

METHODS: The study was based on a localized adaptation of the Cardiff Diabetes Model for the Chinese context. It involved a simulation of the lifetime progression of T2DM in patients, integrating probabilistic sensitivity analyses to explore uncertainties in model parameters. The efficacy and safety parameters for Dapagliflozin monotherapy and its free-dose combination with Metformin were derived from global phase III trials and specific phase III trials in Asian populations, respectively. Since Xigduo had not been directly tested in specific trials for efficacy and safety, its parameters were inferred by modifying the outcomes observed from the free-dose combination therapy. The study included cost data gathered from literature and public databases, with utility value data derived from already published studies.

RESULTS: Lifetime treatment with Xigduo in adult patients with T2DM resulted in an increment of 0.061 QALYs compared to those treated with Dapagliflozin monotherapy, and an increment of 0.013 QALYs compared to patients treated with free-dose combination. Additionally, there was a cost saving over a patient's lifetime.

CONCLUSIONS: Under the scenario where the National Reimbursement Drug List threshold is set at half of the per capita GDP for the year 2022, Xigduo not only demonstrates cost-effectiveness but also stands out for its absolute economic advantage compared to Dapagliflozin monotherapy or free-dose combination. This finding suggests that Xigduo could be a more viable and economically advantageous treatment option for T2DM in the Chinese healthcare setting, especially considering the economic constraints and healthcare priorities of the country.