COST EFFECTIVENESS OF TYPE 2 DIABETES TREATMENTS IN MIDDLE EASTERN COUNTRIES- AN ECONOMIC EVALUATION OF THE EDGE STUDY USING PATIENT LEVEL DATA
Author(s)
McEwan P1, Gordon J1, Foos V2, Lamotte M2, Evans M3, Paldanius P4
1Health Economics and Outcomes Research Ltd, Cardiff, UK, 2IMS Health, Zaventem, Belgium, 3University Hospital Llandough, Cardiff, UK, 4Novartis Pharma AG, Basel, Switzerland
OBJECTIVES: The prevalence of type 2 diabetes (T2D) in Middle Eastern (ME) countries is growing significantly. Also, there is a relative paucity of evidence evaluating clinical and cost-effectiveness of alternative glucose lowering therapies in these countries. A health economic evaluation using an established and validated T2D model was performed based on data from EDGE, a prospective, 1-year, worldwide, ‘real-life’ observational, non-interventional study, which compared effectiveness and safety of treatment intensification with vildagliptin vs. other oral anti-diabetics, as per clinical judgment, in patients with T2D inadequately controlled with monotherapy. METHODS: Costs and outcomes were compared between metformin+vildagliptin (M+V) and metformin+sulphonylurea (M+S) based on data from ME countries. Published multivariate regression equations (derived from EDGE) related patient baseline characteristics (age, diabetes duration, gender, HbA1c, BMI) to total cost (USD), predicted change in quality-adjusted life expectancy (QALE) and life expectancy (LE) for M+V compared with M+S. RESULTS: On average, patients at introduction of dual therapy (n=2,943) were 51.5 years, 62% male, diabetes duration 3.67 years, HbA1c 8.47% and BMI 29.57. Observed change in HbA1c at 1-year following treatment intensification for M+S and M+V was -1.52% and -1.73% (delta: -0.22%, p<0.001). In multivariate analysis, increases in age, duration, % male, were associated with lower gains in QALE (p<0.001); increased baseline HbA1c, BMI and treatment with M+V were associated with significant health gains (p<0.001). Adjusting for baseline characteristics, M+V compared to M+S was associated with lower total costs (43,885 vs. 44,089: delta: -204, p=0.572), an increase in QALE (0.40 vs. 0.31: delta 0.10, p<0.001) and LE (0.30 vs. 0.26: delta: 0.04, p<0.001). CONCLUSIONS: These data highlight the potential role of real-world data in assessing health economic value of T2D treatments in the ME. In patients escalating from monotherapy, M+V was estimated to be associated with lower overall costs and additional health benefit compared to M+S.
Conference/Value in Health Info
2016-05, ISPOR 2016, Washington DC, USA
Value in Health, Vol. 19, No. 3 (May 2016)
Code
PDB32
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders