OBJECTIVES

: To estimate the budget impact of using exenatide extended-release injection in a once-weekly single-dose dual-chamber pen (exenatide-QW) as add-on therapy to metformin in adult patients with type 2 diabetes with inadequate glycemic control in comparison with another GLP-1 receptor agonist (GLP1-RA) currently available in the Mexican public health system.

METHODS

: A budget impact analysis was conducted considering the use of exenatide-QW, compared to liraglutide daily-dose as add-on alternatives to metformin. Efficacy and safety results were obtained from a systematic literature review and data from a meta-analysis comparing clinical outcomes of different GLP1-RA. An institutional perspective was considered. The analysis included different scenarios with incremental percentage of market share (A:25%, B:50%, C:75%, D:100%) in comparison to current use of liraglutide as reported by a public health institution with a national coverage. Economic differences were converted to estimate additional number of patients who could be treated with exenatide-QW maintaining current institutional budget. A sensitivity analysis was conducted to validate the robustness of results. All costs are expressed in 2017 USD

RESULTS

: Exenatide-QW offers annual reduction of institutional budget of 12.8% per patient compared to liraglutide. Results with different percentage of utilization of exenatide-QW demonstrated potential savings (A: $14,784; B: $29,567; C: $44,352; D: $59,137) which represent a reduction of 3.2%, 6.4%, 9.6% or 12.8%, respectively, in the allocated institutional budget. Estimated economic benefits might permit treatment of additional patients within the original budget (A: 16; B: 33; C: 49; D: 66). The sensitivity analysis showed consistency with base case.

CONCLUSIONS

: The utilization of exenatide extended-release injection in a once-weekly single-dose dual-chamber pen is a cost-saving alternative compared to liraglutide that may allow a higher number of patients to get access to the use of an adequate add-on therapy for type 2 diabetes treatment in public health system in Mexico.