1. The Cost-effectiveness of Dulaglutide 1.5mg versus Exenatide QW for the Treatment of Patients with Type 2 Diabetes Mellitus in France
- Author
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Julia Lowin, Mickael Basson, Florence Chartier, Stéphane Roze, Kirsi Norrbacka, Donna Wright, Dionysios Ntais, and Ruba Ayyub
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medicine.medical_specialty ,Cost effectiveness ,Endocrinology, Diabetes and Metabolism ,Type 2 diabetes ,Health benefits ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal Medicine ,Medicine ,030212 general & internal medicine ,Dulaglutide ,Cost–utility ,Exenatide QW ,health care economics and organizations ,Original Research ,business.industry ,030503 health policy & services ,Type 2 Diabetes Mellitus ,medicine.disease ,Cohort ,Emergency medicine ,France ,0305 other medical science ,business ,Exenatide ,medicine.drug - Abstract
Introduction Dulaglutide is a novel onceweekly administered glucagon-like peptide 1 receptor agonist (GLP-1 RA) for the management of type 2 diabetes mellitus (T2DM). The objective of this analysis was to estimate the cost-effectiveness of dulaglutide 1.5 mg versus exenatide QW for the management of T2DM in France. Methods The QuintilesIMS CORE Diabetes Model was used to estimate the expected lifetime direct medical costs and outcomes of T2DM from the perspective of the French National Health Service. In the absence of head-to-head data, relative efficacy was derived from a network meta-analysis. Patient cohort characteristics were derived from the AWARD-2 trial. All patients were assumed to remain on treatment for 2 years before escalating to insulin therapy. Costs included treatment costs and costs associated with long-term complications of T2DM. Utilities were estimated based on a recent systematic review. One-way sensitivity analyses (OWSA) and probabilistic sensitivity analysis (PSA) were conducted. Cost-effectiveness acceptability curves (CEACs) were generated. Results Dulaglutide 1.5 mg was associated with lower costs (lifetime costs €41,562 vs €43,021) and increased health benefits (lifetime quality-adjusted life years: QALYs 9.804 vs 9.757) versus exenatide QW for the treatment of T2DM in France. OWSA and PSA indicated that results were robust across a range of plausible input parameters. The CEAC indicated a 99.5% probability that dulaglutide would be considered cost-effective at a willingness to pay of €30,000. Conclusion Dulaglutide 1.5 mg reduced expected costs and increased expected QALYs when compared against exenatide QW for the treatment of T2DM in France. Compared with exenatide QW, dulaglutide 1.5 mg can provide additional health benefits for patients with T2DM and may result in cost savings for payers. Funding Eli Lilly. Electronic supplementary material The online version of this article (doi:10.1007/s13300-017-0321-0) contains supplementary material, which is available to authorized users.
- Published
- 2017
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