COST-EFFECTIVENESS OF DAPAGLIFLOZIN VERSUS ACARBOSE AS A MONOTHERAPY IN TYPE 2 DIABETES IN CHINA
Author(s)
Gu S1, Mu Y2, Zhai S3, Zeng Y1, Zhen X1, Dong H1
1Zhejiang University, Hangzhou, China, 2Chinese People's Liberation Army General Hospital, Beijing, China, 3Peking University Third Hospital, Beijing, China
OBJECTIVES: Type 2 Diabetes Mellitus (T2DM) and its associated complications pose a heavy disease burden on patients and healthcare systems. Dapagliflozin, a novel sodium-glucose co-transporter-2 inhibitor effectively improves glycaemic control and has added benefits of weight and blood pressure reductions. With a low propensity for hypoglycaemia, acceptable safety tolerability and ease of administration, dapagliflozin is an alternative medication for treatment-naive patients where diet and exercise alone do not provide adequate glyceamic control or other non-insulin anti-diabetic agents are considered inappropriate. Acarbose is a classical alpha-glucosidase inhibitor used by many patients with T2DM and recommended as an alternative medication for first-line therapy in China. This study aims at estimating the long-term cost-effectiveness of dapagliflozin versus acarbose as monotherapy in patients with T2DM in China. METHODS: The Cardiff Diabetes Model, an economic model designed to evaluate the cost-effectiveness of comparator therapies in diabetes was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews, hospital surveys, meta-analysis and indirect treatment comparison were conducted to obtain model-required patient profiles, clinical data and costs. Health insurance costs (2015¥) were estimated over 40 years from a healthcare payer perspective. Univariate and probabilistic sensitivity analyses were performed. RESULTS: The model predicted that dapagliflozin had lower incidences of cardiovascular events, hypoglycemia and mortality events, was associated with a mean incremental benefit of 0.25 quality-adjusted life-years (QALYs) and with a lower cost of ¥8,439 compared with acarbose. This resulted in a cost saving of ¥33,786 per QALY gained with dapagliflozin. Sensitivity analyses determined that the results are robust. CONCLUSIONS: Dapagliflozin is dominant compared with acarbose as monotherapy for Chinese T2DM patients, with greater effectiveness and lower costs. Dapagliflozin offers a well-tolerated and cost-effective alternative medication for treatment-naive patients in China, and may have a direct impact in reducing the disease burden of diabetes.
Conference/Value in Health Info
2016-09, ISPOR Asia Pacific 2016, Singapore
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PDB18
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders