PMID- 31632108
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220410
IS  - 1178-6981 (Print)
IS  - 1178-6981 (Electronic)
IS  - 1178-6981 (Linking)
VI  - 11
DP  - 2019
TI  - Value For Money In The Treatment Of Patients With Type 2 Diabetes Mellitus: 
      Assessing The Long-Term Cost-Effectiveness Of IDegLira Versus iGlarLixi In Italy.
PG  - 605-614
LID - 10.2147/CEOR.S218746 [doi]
AB  - OBJECTIVE: Italian treatment guidelines for type 2 diabetes mellitus (T2DM) 
      target good glycemic control but acknowledge the associated risk of hypoglycemia. 
      Unlike traditional antidiabetic therapies, modern treatment options such as 
      fixed-ratio combinations of basal insulin and glucagon-like peptide 1 receptor 
      agonists are associated with improved glycemic control, reduced body weight and 
      low risk of hypoglycemia. The cost-effectiveness of the fixed-ratio combinations 
      of basal insulin and glucagon-like peptide 1 receptor agonists IDegLira and 
      iGlarLixi was assessed for Italy in patients with T2DM uncontrolled on basal 
      insulin, to evaluate how short-term clinical benefits translate into long-term 
      health economic outcomes. METHODS: The IQVIA CORE Diabetes Model was used to 
      project clinical and economic outcomes over patient lifetimes. Treatment effects 
      were sourced from an indirect treatment comparison. The analysis captured direct 
      medical costs (expressed in 2017 Euros) from the perspective of the Italian 
      National Health Service (NHS) and patient-related quality of life. Sensitivity 
      analyses were performed. RESULTS: IDegLira was associated with gains of 0.09 life 
      years and 0.13 quality-adjusted life years (QALYs) relative to iGlarLixi, due to 
      a lower cumulative incidence and delayed onset of diabetes-related complications. 
      IDegLira was associated with an incremental cost of EUR 930 over patient 
      lifetimes, leading to an incremental cost-effectiveness ratio of EUR 7,386 per 
      QALY gained. CONCLUSION: Over the lifetime of patients with T2DM uncontrolled on 
      basal insulin, IDegLira was associated with improved clinical outcomes at higher 
      costs relative to iGlarLixi. At a willingness-to-pay threshold of EUR 30,000 per 
      QALY gained, IDegLira was considered to be cost-effective versus iGlarLixi from 
      the perspective of the Italian NHS.
CI  - (c) 2019 Pohlmann et al.
FAU - Pohlmann, Johannes
AU  - Pohlmann J
AD  - Health Economics, Ossian Health Economics and Communications, Basel 4051, 
      Switzerland.
FAU - Montagnoli, Roberta
AU  - Montagnoli R
AD  - External Affairs-Region Europe, Novo Nordisk SpA, Rome IT00144, Italy.
FAU - Lastoria, Giusi
AU  - Lastoria G
AUID- ORCID: 0000-0002-2276-447X
AD  - Medical Advice, Novo Nordisk SpA, Rome IT00144, Italy.
FAU - Parekh, Witesh
AU  - Parekh W
AD  - European HEOR, Nova Nordisk Ltd, West Sussex RH6 0PA, UK.
FAU - Markert, Marie
AU  - Markert M
AD  - Global Market Access, Novo Nordisk A/S, Soborg DK-2860, Denmark.
FAU - Hunt, Barnaby
AU  - Hunt B
AUID- ORCID: 0000-0001-5420-279X
AD  - Health Economics, Ossian Health Economics and Communications, Basel 4051, 
      Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20191007
PL  - New Zealand
TA  - Clinicoecon Outcomes Res
JT  - ClinicoEconomics and outcomes research : CEOR
JID - 101560564
PMC - PMC6789179
OTO - NOTNLM
OT  - IDegLira
OT  - Italy
OT  - cost-effectiveness
OT  - fixed-ratio combination
OT  - iGlarLixi
OT  - type 2 diabetes
COIS- Marie Markert: Employee of Novo Nordisk and reports personal fees from Novo 
      Nordisk A/S, outside the submitted work. Giusi Lastoria: Employee of Novo 
      Nordisk. Roberta Montagnoli: Employee of Novo Nordisk. Witesh Parekh: Employee of 
      Novo Nordisk. Johannes Pohlmann: Employee of Ossian Health Economics and 
      Communications, which received consulting fees from Novo Nordisk for the conduct 
      of the study and preparation of the manuscript. Barnaby Hunt: Employee of Ossian 
      Health Economics and Communications, which received consulting fees from Novo 
      Nordisk for the conduct of the study and preparation of the manuscript. The 
      authors report no other conflicts of interest in this work.
EDAT- 2019/10/22 06:00
MHDA- 2019/10/22 06:01
PMCR- 2019/10/07
CRDT- 2019/10/22 06:00
PHST- 2019/06/08 00:00 [received]
PHST- 2019/09/06 00:00 [accepted]
PHST- 2019/10/22 06:00 [entrez]
PHST- 2019/10/22 06:00 [pubmed]
PHST- 2019/10/22 06:01 [medline]
PHST- 2019/10/07 00:00 [pmc-release]
AID - 218746 [pii]
AID - 10.2147/CEOR.S218746 [doi]
PST - epublish
SO  - Clinicoecon Outcomes Res. 2019 Oct 7;11:605-614. doi: 10.2147/CEOR.S218746. 
      eCollection 2019.