[Cost-effectiveness of exenatide versus insulin glargine in Spanish patients with obesity and type 2 diabetes mellitus]

Endocrinol Nutr. 2011 Aug-Sep;58(7):331-40. doi: 10.1016/j.endonu.2011.04.005. Epub 2011 Jun 29.
[Article in Spanish]

Abstract

Background and objectives: Exenatide, a GLP-1 receptor agonist for adjuvant treatment of type 2 diabetes mellitus (T2DM), has been shown to be as effective as insulin glargine (IG) for reducing glycated hemoglobin levels combined with metformin or/and sulphonylureas. Exenatide is associated to weight reduction and a higher incidence of gastrointestinal adverse events. The objective of this study was to assess the cost-effectiveness of exenatide as compared to IG in obese patients with T2DM not achieving an adequate blood glucose control from the perspective of the Spanish healthcare system.

Methods: Pharmacoeconomic model inputs were obtained from an obese subpopulation (BMI ≥ 30 k/m(2)) of an international, randomized, controlled clinical trial comparing exenatide with IG in poorly controlled T2DM patients, and were supplemented with country-specific data.

Results: Exenatide was associated to improvements in life-years gained and quality-adjusted life years (QALYs) by 0.11 and 0.62 respectively versus IG. Direct costs were € 9,306 higher as compared to IG (€ 47,010 versus € 37,704, with increased pharmacy costs as the main driver). Exenatideís incremental cost-effectiveness ratio was € 15,068 per QALY gained versus IG.

Conclusions: Exenatide was associated to greater clinical benefits and higher costs in obese T2DM patients as compared to IG. Considering a willingness-to-pay threshold of € 30,000 per QALY gained in the Spanish setting, exenatide represents an efficient option in comparison with IG.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 2 / complications*
  • Exenatide
  • Female
  • Humans
  • Hypoglycemic Agents / economics*
  • Hypoglycemic Agents / therapeutic use*
  • Insulin Glargine
  • Insulin, Long-Acting / economics*
  • Insulin, Long-Acting / therapeutic use*
  • Male
  • Middle Aged
  • Obesity / complications*
  • Peptides / economics*
  • Peptides / therapeutic use*
  • Venoms / economics*
  • Venoms / therapeutic use*

Substances

  • Hypoglycemic Agents
  • Insulin, Long-Acting
  • Peptides
  • Venoms
  • Insulin Glargine
  • Exenatide