PMID- 30706364
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210421
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 10
IP  - 2
DP  - 2019 Apr
TI  - Treating Patients with Type 2 Diabetes Mellitus Uncontrolled on Basal Insulin in 
      the Czech Republic: Cost-Effectiveness of IDegLira Versus iGlarLixi.
PG  - 493-508
LID - 10.1007/s13300-019-0569-7 [doi]
AB  - INTRODUCTION: Few patients with type 2 diabetes mellitus (T2DM) achieve 
      recommended glycemic control targets in the Czech Republic. Novel therapies, such 
      as fixed-ratio combinations of basal insulin plus glucagon-like peptide-1 
      receptor agonists, may contribute to better glycemic control. In the analysis 
      presented here, the present analysis assessed the long-term cost-effectiveness of 
      two fixed-ratio combinations, IDegLira (insulin degludec/liraglutide) and 
      iGlarLixi (insulin glargine/lixisenatide), for the treatment of patients with 
      T2DM inadequately controlled with basal insulin from a healthcare payer 
      perspective in the Czech Republic. METHODS: A cost-effectiveness analysis was 
      performed over patient lifetimes using the IQVIA CORE Diabetes Model. Treatment 
      effects were obtained from an indirect treatment comparison as no head-to-head 
      data for IDegLira versus iGlarLixi are currently available. IDegLira was compared 
      with two iGlarLixi pens (100 U/mL insulin glargine + 33 mug/mL and 50 mug/mL of 
      lixisenatide, respectively). Direct medical costs associated with pharmaceutical 
      interventions, screening and diabetes-related complications were captured. 
      Deterministic and probabilistic sensitivity analyses were performed. RESULTS: 
      IDegLira was associated with gains in life expectancy of 0.11 years and in 
      quality-adjusted life expectancy of 0.14 quality-adjusted life-years (QALYs) 
      versus iGlarLixi, due to a lower cumulative incidence and delayed onset of 
      diabetes-related complications. IDegLira was also associated with higher 
      projected costs due to higher acquisition costs; however, these were partially 
      offset by cost savings from avoided complications. IDegLira was associated with 
      incremental cost-effectiveness ratios of Czech Koruna (CZK) 695,998 and 
      CZK 348,323 per QALY gained versus iGlarLixi pens containing 33 and 50 mug/mL of 
      lixisenatide, respectively. These ratios were below the commonly used 
      willingness-to-pay threshold of CZK 1,200,000 per QALY gained. CONCLUSION: The 
      present analysis indicated that IDegLira was associated with clinical benefits 
      relative to iGlarLixi over patient lifetimes and was likely to be cost-effective 
      in the treatment of patients with T2DM uncontrolled on basal insulin in the Czech 
      Republic. FUNDING: Novo Nordisk. Plain language summary is available for this 
      article.
FAU - Pohlmann, Johannes
AU  - Pohlmann J
AUID- ORCID: 0000-0002-8065-755X
AD  - Ossian Health Economics and Communications, Basel, Switzerland. 
      poehlmann@ossianconsulting.com.
FAU - Russel-Szymczyk, Monika
AU  - Russel-Szymczyk M
AD  - Novo Nordisk Pharma Sp. z.o.o., Warsaw, Poland.
FAU - Holik, Pavel
AU  - Holik P
AD  - Novo Nordisk s.r.o., Prague, Czech Republic.
FAU - Rychna, Karel
AU  - Rychna K
AD  - Novo Nordisk s.r.o., Prague, Czech Republic.
FAU - Hunt, Barnaby
AU  - Hunt B
AUID- ORCID: 0000-0001-5420-279X
AD  - Ossian Health Economics and Communications, Basel, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20190131
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC6437226
OTO - NOTNLM
OT  - Cost-effectiveness
OT  - Czech Republic
OT  - Fixed-ratio combination
OT  - IDegLira
OT  - Type 2 diabetes
OT  - iGlarLixi
EDAT- 2019/02/02 06:00
MHDA- 2019/02/02 06:01
PMCR- 2019/01/31
CRDT- 2019/02/02 06:00
PHST- 2018/12/11 00:00 [received]
PHST- 2019/02/02 06:00 [pubmed]
PHST- 2019/02/02 06:01 [medline]
PHST- 2019/02/02 06:00 [entrez]
PHST- 2019/01/31 00:00 [pmc-release]
AID - 10.1007/s13300-019-0569-7 [pii]
AID - 569 [pii]
AID - 10.1007/s13300-019-0569-7 [doi]
PST - ppublish
SO  - Diabetes Ther. 2019 Apr;10(2):493-508. doi: 10.1007/s13300-019-0569-7. Epub 2019 
      Jan 31.