Cost-effectiveness of saxagliptin (Onglyza®) in type 2 diabetes in Sweden

Prim Care Diabetes. 2012 Jul;6(2):127-36. doi: 10.1016/j.pcd.2011.09.003. Epub 2011 Oct 15.

Abstract

Aim: The objective of this study was to investigate the cost-effectiveness of saxagliptin (Onglyza(®)), a DPP-4 inhibitor, plus metformin compared with a sulphonylurea (SU) (Glipizide) plus metformin in Swedish patients not well controlled on metformin alone.

Methods: Data from a 52-week clinical trial comparing saxagliptin and glipizide in combination with metformin was used in a simulation model to estimate long term complications in a cohort of type 2 diabetes patients. The model estimates the incidence of microvascular and macrovascular complications, diabetes-specific mortality, all-cause mortality, and ultimately, costs and quality-adjusted life years (QALYs) associated with the investigated treatment strategies. Costs and QALYs were estimated for a lifetime time horizon.

Results: Compared with SU+metformin, the cost per QALY gained with saxagliptin+metformin is approximately SEK 91,000. Patients on saxagliptin+metformin gain 0.10 QALYs on average, at an incremental cost of around SEK 9500. The cost-effectiveness results were robust to various sensitivity analyses.

Conclusions: This study demonstrates that, over a patient's lifetime, the addition of saxagliptin to metformin is associated with improvements in quality-adjusted life years compared with SU in patients with type 2 diabetes. Saxagliptin treatment is a cost-effective treatment alternative for type 2 diabetes in patients not well-controlled on metformin alone.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adamantane / adverse effects
  • Adamantane / analogs & derivatives*
  • Adamantane / economics
  • Adamantane / therapeutic use
  • Biomarkers / blood
  • Computer Simulation
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / economics*
  • Diabetes Mellitus, Type 2 / mortality
  • Dipeptides / adverse effects
  • Dipeptides / economics*
  • Dipeptides / therapeutic use*
  • Dipeptidyl-Peptidase IV Inhibitors / adverse effects
  • Dipeptidyl-Peptidase IV Inhibitors / economics*
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use*
  • Drug Costs*
  • Drug Therapy, Combination
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Male
  • Metformin / economics
  • Metformin / therapeutic use
  • Middle Aged
  • Models, Economic
  • Quality-Adjusted Life Years
  • Sulfonylurea Compounds / economics
  • Sulfonylurea Compounds / therapeutic use
  • Sweden / epidemiology
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Dipeptides
  • Dipeptidyl-Peptidase IV Inhibitors
  • Glycated Hemoglobin A
  • Sulfonylurea Compounds
  • hemoglobin A1c protein, human
  • Metformin
  • saxagliptin
  • Adamantane