摘要
Background: There are significant differences in costs and effectiveness among the second-line treatment options for type 2 diabetes (T2DM). We aimed to evaluate the cost-effectiveness of the second-line anti-diabetic therapy in T2DM patients inadequately controlled on metformin (MET) in Taiwan from the perspective of the National Health Insurance (NHI). Methods: The Cardiff T2DM model was used to predict the occurrence of mortality, diabetes-related complications, and drug adverse events. Five second-line treatments were selected for the analysis: sodium-glucose cotransporter 2 inhibitors (SGLT-2-i), glucagon-like peptide-1 receptor agonists (GLP-1-RA), dipeptidyl peptidase-4 inhibitor (DPP-4-i), sulfonylurea (SU), and insulin (INS). Treatment efficacy data were obtained from meta-analyses and randomized clinical trials, whereas cost data were derived from the NHI databases. Results: The analysis found that SU + MET (DPP-4-i as triple therapy) had the lowest cost, and SU + MET (SGLT-2-i as triple therapy) was associated with a mean incremental benefit of 0.47 quality-adjusted life years (QALYs) at an incremental cost of NT$2769, resulting in an incremental cost-effectiveness ratio (ICER) of NT$5840/QALY. Compared to their next less costly strategies, SGLT-2-i + MET (SU as triple therapy) and SGLT-2-i + MET (DPP-4-i as triple therapy) had ICER values of NT$63,170/QALY and NT$64,090/QALY, respectively. These results were fairly robust to extensive sensitivity analyses, but were relatively sensitive to baseline HbA1c, HbA1c threshold, and utilities. Conclusion: The addition of either SU or SGLT-2-i to MET was found to be cost-effective, using the 2019 forecast for GDP per capita of Taiwan (NT$770,770) as the willingness to pay (WTP) threshold.
原文 | 英語 |
---|---|
頁(從 - 到) | 1619-1626 |
頁數 | 8 |
期刊 | Current Medical Research and Opinion |
卷 | 36 |
發行號 | 10 |
DOIs | |
出版狀態 | 已發佈 - 9月 2020 |
ASJC Scopus subject areas
- 一般醫學
指紋
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Cost-utility analysis of second-line anti-diabetic therapy in patients with type 2 diabetes mellitus inadequately controlled on metformin
Chien, C.-L. (Contributor), Chen, Y.-C. (Contributor), Malone, D. C. (Creator), Peng, Y.-L. (Contributor) & Ko, Y. (Creator), Taylor & Francis, 2020
DOI: 10.6084/m9.figshare.12871744.v1, https://tandf.figshare.com/articles/dataset/Cost-utility_analysis_of_second-line_anti-diabetic_therapy_in_patients_with_type_2_diabetes_mellitus_inadequately_controlled_on_metformin/12871744/1
資料集: Dataset