PMID- 29698175
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 2212-1102 (Electronic)
IS  - 2212-1099 (Linking)
VI  - 8
DP  - 2015 Dec
TI  - Cost-Effectiveness of Canagliflozin versus Sitagliptin as Add-on to Metformin in 
      Patients with Type 2 Diabetes Mellitus in Mexico.
PG  - 8-19
LID - S2212-1099(15)00003-5 [pii]
LID - 10.1016/j.vhri.2015.01.002 [doi]
AB  - OBJECTIVE: To assess the cost-effectiveness of canagliflozin versus sitagliptin 
      for the treatment of type 2 diabetes mellitus (T2DM) as an add-on to metformin in 
      Mexico. METHODS: A validated model (Economic and Health Outcomes [ECHO]-T2DM) was 
      used to estimate the cost-effectiveness of canagliflozin 300 or 100 mg versus 
      sitagliptin 100 mg in patients with T2DM inadequately controlled on metformin 
      monotherapy. Data from a head-to-head, phase III clinical trial, including 
      patients' baseline demographic characteristics, biomarker values, and treatment 
      effects, were used to simulate outcomes and resource use over 20 years from the 
      perspective of the Mexican health care system. Costs of complications and adverse 
      events were tailored to the Mexican setting and discounted at 5%. 
      Cost-effectiveness was assessed using willingness-to-pay thresholds equivalent to 
      1 times the gross domestic product per capita (locally perceived to be "very 
      cost-effective") and 3 times the gross domestic product per capita (locally 
      perceived to be "cost-effective") on the basis of recommendations of the Mexican 
      government and the World Health Organization. RESULTS: Owing primarily to better 
      glycated hemoglobin (HbA(1c)), body weight, and systolic blood pressure values, 
      canagliflozin 300 and 100 mg were associated with an incremental benefit of 0.16 
      and 0.06 quality-adjusted life-years (QALYs) versus sitagliptin 100 mg, 
      respectively, over 20 years. The mean differences in cost for canagliflozin 300 
      and 100 mg versus sitagliptin 100 mg were Mexican pesos (MXP) 1797 (US $134) and 
      MXP 7262 (US $540), respectively, resulting in a cost per QALY gained of MXP 
      11,210 (US $834) and MXP 128,883 (US $9590), respectively. Both of these 
      cost-effectiveness ratios are below the very cost-effective willingness-to-pay 
      threshold in Mexico. The general finding that canagliflozin is cost-effective 
      versus sitagliptin in Mexico was supported by sensitivity analyses. CONCLUSION: 
      In Mexico, both doses of canagliflozin are likely to be cost-effective versus 
      sitagliptin in patients with T2DM who have inadequate glucose control on 
      metformin, primarily because of better biomarker control and higher QALYs.
CI  - Copyright (c) 2015 International Society for Pharmacoeconomics and Outcomes 
      Research (ISPOR). Published by Elsevier Inc. All rights reserved.
FAU - Neslusan, Cheryl
AU  - Neslusan C
AD  - Janssen Global Services, LLC, Raritan, NJ, USA. Electronic address: 
      cneslusa@its.jnj.com.
FAU - Teschemaker, Anna
AU  - Teschemaker A
AD  - Janssen Global Services, LLC, Raritan, NJ, USA.
FAU - Johansen, Pierre
AU  - Johansen P
AD  - The Swedish Institute for Health Economics, Lund, Sweden.
FAU - Willis, Michael
AU  - Willis M
AD  - The Swedish Institute for Health Economics, Lund, Sweden.
FAU - Valencia-Mendoza, Atanacio
AU  - Valencia-Mendoza A
AD  - Janssen Cilag Mexico, Mexico.
FAU - Puig, Andrea
AU  - Puig A
AD  - Johnson and Johnson International, New Brunswick, NJ, USA.
LA  - eng
PT  - Journal Article
DEP - 20150603
PL  - United States
TA  - Value Health Reg Issues
JT  - Value in health regional issues
JID - 101592642
OTO - NOTNLM
OT  - SGLT2 inhibitor
OT  - cost-effectiveness
OT  - dipeptidyl peptidase-4 inhibitor
OT  - type 2 diabetes
EDAT- 2015/12/01 00:00
MHDA- 2015/12/01 00:01
CRDT- 2018/04/27 06:00
PHST- 2014/05/31 00:00 [received]
PHST- 2014/10/24 00:00 [revised]
PHST- 2015/01/06 00:00 [accepted]
PHST- 2018/04/27 06:00 [entrez]
PHST- 2015/12/01 00:00 [pubmed]
PHST- 2015/12/01 00:01 [medline]
AID - S2212-1099(15)00003-5 [pii]
AID - 10.1016/j.vhri.2015.01.002 [doi]
PST - ppublish
SO  - Value Health Reg Issues. 2015 Dec;8:8-19. doi: 10.1016/j.vhri.2015.01.002. Epub 
      2015 Jun 3.