PMID- 28281218
OWN - NLM
STAT- MEDLINE
DCOM- 20170911
LR  - 20221207
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Print)
IS  - 0741-238X (Linking)
VI  - 34
IP  - 4
DP  - 2017 Apr
TI  - Evaluation of the Short-Term Cost-Effectiveness of IDegLira Versus Continued 
      Up-Titration of Insulin Glargine U100 in Patients with Type 2 Diabetes in the 
      USA.
PG  - 954-965
LID - 10.1007/s12325-017-0502-2 [doi]
AB  - INTRODUCTION: Effective glycemic control can reduce the risk of complications and 
      their related costs in type 2 diabetes mellitus (T2DM). However, many patients 
      fail to reach glycemic targets, often because of adverse effects of treatment 
      (including hypoglycemia or weight gain). The present analysis evaluated the 
      short-term cost-effectiveness of IDegLira versus continued up-titration of 
      insulin glargine U100 in patients with T2DM failing to achieve glycemic control 
      on basal insulin in the US setting. METHODS: The cost per patient achieving 
      treatment target (cost of control) was assessed for various single and composite 
      endpoints for the entire trial population and in patients with baseline glycated 
      hemoglobin (HbA1c) >8.0% and HbA1c >9.0%. The proportions of patients achieving 
      treatment targets were analyzed using data obtained in the DUAL V study. Costs 
      were accounted based on published wholesale acquisition costs. RESULTS: When 
      assessing the full trial population, IDegLira was associated with lower annual 
      cost of control than continued up-titration of insulin glargine U100 for patients 
      achieving HbA1c </=6.5% without confirmed hypoglycemia (by $10,608), HbA1c </=6.5% 
      without weight gain (by $29,215), and HbA1c </=6.5% without confirmed hypoglycemia 
      and weight gain (by $57,351). A similar pattern was observed when multifactorial 
      treatment targets were based on achieving a glycemic target of 7.0%. When only 
      HbA1c was considered, IDegLira was associated with a lower cost per patient 
      achieving HbA1c </=6.5% (by $3306) but cost of control was equivalent for a target 
      of HbA1c <7.0%. In patients with baseline HbA1c >8.0% and HbA1c >9.0%, IDegLira 
      was associated with a lower cost of control for all treatment targets. 
      CONCLUSION: The significantly greater clinical efficacy in terms of bringing 
      patients to treatment targets identified in the DUAL V study results in lower 
      cost of control values for IDegLira versus continued up-titration of insulin 
      glargine U100 in the USA. This suggests IDegLira is a cost-effective treatment 
      option in the USA. FUNDING: Novo Nordisk A/S and Novo Nordisk Inc.
FAU - Hunt, Barnaby
AU  - Hunt B
AUID- ORCID: 0000-0001-5420-279X
AD  - Ossian Health Economics and Communications, Basel, Switzerland. 
      hunt@ossianconsulting.com.
FAU - Mocarski, Michelle
AU  - Mocarski M
AD  - Novo Nordisk Inc., Plainsboro, NJ, USA.
FAU - Valentine, William J
AU  - Valentine WJ
AD  - Ossian Health Economics and Communications, Basel, Switzerland.
FAU - Langer, Jakob
AU  - Langer J
AD  - Novo Nordisk A/S, Soborg, Denmark.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20170309
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Blood Glucose)
RN  - 0 (Drug Combinations)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (IDegLira)
RN  - 0 (Insulin, Long-Acting)
RN  - 2ZM8CX04RZ (Insulin Glargine)
RN  - 839I73S42A (Liraglutide)
EIN - Adv Ther. 2017 Jun;34(6):1500-1501. PMID: 28523624
MH  - Blood Glucose/drug effects
MH  - Cost-Benefit Analysis
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Dose-Response Relationship, Drug
MH  - Drug Combinations
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Hypoglycemia/chemically induced
MH  - Hypoglycemic Agents/*economics/therapeutic use
MH  - Insulin Glargine/*economics/therapeutic use
MH  - Insulin, Long-Acting/*economics/therapeutic use
MH  - Liraglutide/*economics/therapeutic use
MH  - Weight Gain
PMC - PMC5435780
OTO - NOTNLM
OT  - Cost
OT  - Cost-effectiveness
OT  - Endocrinology
OT  - IDegLira
OT  - Type 2 diabetes mellitus
OT  - USA
EDAT- 2017/03/11 06:00
MHDA- 2017/09/12 06:00
PMCR- 2017/03/09
CRDT- 2017/03/11 06:00
PHST- 2017/01/23 00:00 [received]
PHST- 2017/03/11 06:00 [pubmed]
PHST- 2017/09/12 06:00 [medline]
PHST- 2017/03/11 06:00 [entrez]
PHST- 2017/03/09 00:00 [pmc-release]
AID - 10.1007/s12325-017-0502-2 [pii]
AID - 502 [pii]
AID - 10.1007/s12325-017-0502-2 [doi]
PST - ppublish
SO  - Adv Ther. 2017 Apr;34(4):954-965. doi: 10.1007/s12325-017-0502-2. Epub 2017 Mar 
      9.