A UK ANALYSIS OF THE DIFFERENTIAL DRUG COSTS PER 1% POINT DECREASE IN HBA1C AMONG ANTIHYPERGLYCEMIC AGENTS THAT INHIBIT SGLT2

Author(s)

Schroeder M1, Schubert A2, Chan E3, Neslusan C4
1Janssen-Cilag UK, High Wycombe, UK, 2Janssen-Cilag Poland, Warsaw, Poland, 3Janssen-Cilag Ltd, High Wycombe, UK, 4Janssen Global Services, LLC, Raritan, NJ, USA

OBJECTIVES:  In the seminal UK Prospective Diabetes Study, a 1% reduction in HbA1c was associated with important risk reductions in any diabetes-related end point, diabetes-related deaths, myocardial infarction, and microvascular complications. Here, we examine the drug cost of canagliflozin 100 and 300mg, dapagliflozin 10mg, and empagliflozin 10 and 25mg per a 1% reduction in HbA1c. METHODS:  Drug cost per response was calculated using HbA1c-lowering data from two sources: 1) the individual product labels and 2) network meta-analyses (NMAs) of clinical trials, which preserve randomization by comparing relative treatment effects. Included studies evaluated each drug as dual therapy (metformin background) and triple therapy (metformin plus sulfonylurea background) in patients with type 2 diabetes mellitus at 26 weeks. The average cost per response for each drug was calculated as the prescription drug cost for each agent/dose in the UK (£238 for 26 weeks of treatment) divided by (1) the average placebo-adjusted HbA1c reduction at each relative line of therapy in the trials reported in the product label, or (2) the mean HbA1c reduction from baseline from the relevant NMA. RESULTS:  Costs per response varied between the agents/doses within both analyses; still trends between analyses mirrored each other. The costs per response for canagliflozin 100mg in dual and triple therapy ranged from £317 to £384, and for canagliflozin 300mg from £238 to £309. The costs per response for dapagliflozin 10mg in dual and triple therapy ranged from £345 to £580. The cost per response for empagliflozin 10mg in dual and triple therapy ranged from £366 to £417, and for empagliflozin 25mg from £372 to £396, respectively. CONCLUSIONS:  These results suggest that adding canagliflozin in patients inadequately controlled on dual or triple therapy would result in lower drug expenditures per responder than alternative agents that inhibit SGLT2.

Conference/Value in Health Info

2016-05, ISPOR 2016, Washington DC, USA

Value in Health, Vol. 19, No. 3 (May 2016)

Code

PDB25

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Diabetes/Endocrine/Metabolic Disorders

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