PMID- 23621944
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130514
LR  - 20240318
IS  - 2191-1991 (Print)
IS  - 2191-1991 (Electronic)
IS  - 2191-1991 (Linking)
VI  - 3
IP  - 1
DP  - 2013 Apr 27
TI  - Treatment of type 2 diabetes with saxagliptin: a pharmacoeconomic evaluation in 
      Argentina.
PG  - 11
LID - 10.1186/2191-1991-3-11 [doi]
AB  - BACKGROUND: The increasing prevalence of diabetes and its inadequate management 
      results in a heavy burden of the disease for the patients, the health and the 
      productive system and the overall community. Consequently, it is necessary to 
      have new effective drugs to treat people with diabetes to decrease such burden. 
      DPP-4 inhibitors can help to cope with this demand, but its usage is challenged 
      by its apparent high cost. The aim of the current study was to compare a 
      simulated cost-effectiveness ratio of metformin (MET) plus one drug of the DPP-4 
      inhibitors family, saxagliptin (SAXA) or sulfonylurea (SU) treatment during a 
      20-year period, from the perspective of the social security system, in a cohort 
      of people with Type 2 diabetes (T2DM) who did not attain glycosylated hemoglobin 
      treatment target values only with MET. METHODS: A discrete event simulation model 
      (Cardiff diabetes model) based on UKPDS 68 was used to simulate disease 
      progression and to estimate the economic and health treatment consequences in 
      people with T2DM. The clinical efficacy parameters for SAXA administration were 
      obtained from the literature; local standard costs were considered for drug 
      acquisition, adverse events (AEs), and micro/macrovascular complications. Costs 
      were expressed in US dollars (2009) with an annual 3.5% discount and a 20-year 
      time horizon. RESULTS: The SAXA + MET treated group had a lower number of 
      non-fatal events than the SU + MET treated group. The model also predicted a 
      lower number of fatal macrovascular events for the SAXA + MET group (149.6 vs. 
      152.8). The total cost of the SAXA + MET cohort was 15% higher than that of the 
      SU + MET cohort. Treatment with SAXA + MET resulted in a higher number of 
      quality-adjusted life years (QALYs) (9.54 vs. 9.32) and life-years gained (LYGs) 
      (20.84 vs. 20.76) compared to those treated with SU + MET. The incremental cost 
      per QALY and LYG gained was $7,374 and $20,490, respectively. CONCLUSIONS: 
      According to the criteria proposed by the Commission on Macroeconomics and 
      Health, the use of the combination SAXA + MET is highly cost-effective in 
      Argentina.
FAU - Elgart, Jorge F
AU  - Elgart JF
AD  - CENEXA - Center of Experimental and Applied Endocrinology (UNLP-CONICET La 
      Plata), PAHO/WHO Collaborating Center for Diabetes, La Plata, Argentina. 
      jelgart@cenexa.org.
FAU - Caporale, Joaquin E
AU  - Caporale JE
FAU - Gonzalez, Lorena
AU  - Gonzalez L
FAU - Aiello, Eleonora
AU  - Aiello E
FAU - Waschbusch, Maximiliano
AU  - Waschbusch M
FAU - Gagliardino, Juan J
AU  - Gagliardino JJ
LA  - eng
PT  - Journal Article
DEP - 20130427
PL  - Germany
TA  - Health Econ Rev
JT  - Health economics review
JID - 101583209
PMC - PMC3651339
EDAT- 2013/04/30 06:00
MHDA- 2013/04/30 06:01
PMCR- 2013/04/27
CRDT- 2013/04/30 06:00
PHST- 2012/08/09 00:00 [received]
PHST- 2013/04/19 00:00 [accepted]
PHST- 2013/04/30 06:00 [entrez]
PHST- 2013/04/30 06:00 [pubmed]
PHST- 2013/04/30 06:01 [medline]
PHST- 2013/04/27 00:00 [pmc-release]
AID - 2191-1991-3-11 [pii]
AID - 10.1186/2191-1991-3-11 [doi]
PST - epublish
SO  - Health Econ Rev. 2013 Apr 27;3(1):11. doi: 10.1186/2191-1991-3-11.