METHODS: A systematic literature search of pharmacoeconomic studies on GLP-1 receptors agonist vs. DPP-4 inhibitor was carried out in following databases: PubMed, Embase, Cochrane Library, and Chinese Knowledge Infrastructure (CNKI) (from the inception to April.2014). Two review authors independently applied the inclusion criteria, assessed trial quality, and extracted the data. The methodological qualities were evaluated by a scale of 26 items which developed based on 3 economic evaluation principles and guidelines (Drummond’s, Ramsey’s and Papaioannou’s) , and the data were analyzed using descriptive analysis．

RESULTS: According to the inclusion and exclusion criteria，6 randomized controlled clinical trials and modeling studies were selected, including 4 studies of liraglutide+ metformin vs. sitagliptin+ metformin, 1 study of exenatide+ metformin vs. sitagliptin + metformin, and 1 study of exenatide vs. sitagliptin. The methodological quality of them were scored 19-24(total score was 26). There were 5 CUA studies which conducted a long-term simulation（≥35 years）using CDM model, and 1 short-term CEA study. 4 studies used ICER and 2 used C/E as outcomes. Liraglutide is more cost-effective than sitagliptin because the ICER of liraglutide vs. sitagliptin is $25742/QALY in USA, £9851/QALY in England and EUR13266/QALY in Spain. All the reported ICERs were below the implemented country-specific thresholds. The results of 2 studies of exenatide vs. sitagliptin were opposite.

CONCLUSIONS: Present published literatures showed GLP-1receptor agonist may be more cost-effective than DPP-4 inhibitor. But the conclusions remain to be confirmed further by more high quality studies.