OBJECTIVES: IDegLira is a fixed-ratio combination [FRC] of insulin degludec and the glucagon-like peptide-1 [GLP-1] receptor agonist liraglutide for treatment of patients with type 2 diabetes [T2D]. In clinical and real-world studies, IDegLira consistently reduced glycated hemoglobin [HbA1c] and body weight, at low risk of hypoglycemia. Reductions in HbA1c and body mass are associated with lower long-term risks of diabetes-related complications. Given these clinical benefits, the long-term cost-effectiveness of IDegLira versus iGlarLixi (FRC of insulin glargine and lixisenatide) was assessed for Denmark.

METHODS: The IQVIA CORE Diabetes Model was used to project clinical and cost outcomes over patient lifetimes, from the Danish healthcare payer’s perspective. Cohort characteristics for patients with T2D, inadequately controlled on metformin and basal insulin, were obtained from the DUAL II study. DUAL II also provided treatment effects for IDegLira, from which iGlarLixi treatment effects were calculated using comparative results on HbA1c and body weight from a recent indirect comparison. Patients were assumed to intensify to a basal-bolus regimen after 3 years. Utilities, medication and complications costs, expressed in 2018 Danish kroner [DKK], were sourced from the published literature and Danish tariffs.

RESULTS: Treatment with IDegLira was associated with gains in life expectancy (0.08 life-years) and quality-adjusted life expectancy (0.12 quality-adjusted life-years [QALYs]) versus treatment with iGlarLixi as patients receiving IDegLira experienced fewer diabetes-related complications. Compared with iGlarLixi, IDegLira was associated with incremental costs of DKK 13,830. IDegLira was associated with an incremental cost-effectiveness ratio of DKK 182,451 per QALY gained versus iGlarLixi. Sensitivity analyses confirmed results for a wide range of model inputs.

CONCLUSIONS: In patients with inadequately controlled T2D on basal insulin, IDegLira was projected to improve clinical outcomes compared with iGlarLixi in Denmark. Long-term cost-effectiveness analysis demonstrated that IDegLira was likely to be cost-effective versus iGlarLixi from the Danish healthcare payer’s perspective.