PMID- 32700188
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 11
IP  - 9
DP  - 2020 Sep
TI  - Long-Term Cost-Effectiveness Analyses of Empagliflozin Versus Oral Semaglutide, 
      in Addition to Metformin, for the Treatment of Type 2 Diabetes in the UK.
PG  - 2041-2055
LID - 10.1007/s13300-020-00883-1 [doi]
AB  - INTRODUCTION: International guidelines recommend treatment with a sodium-glucose 
      cotransporter-2 (SGLT-2) inhibitor or glucagon-like peptide-1 (GLP-1) receptor 
      agonist for treatment intensification in type 2 diabetes mellitus (T2DM) patients 
      with progression on metformin. In the randomised, controlled, Peptide Innovation 
      for Early Diabetes Treatment (PIONEER) 2 trial, the SGLT-2 inhibitor 
      empagliflozin was compared with the GLP-1 receptor agonist oral semaglutide, in 
      addition to metformin. The aim of the current study was to assess the long-term 
      cost-effectiveness of empagliflozin 25 mg versus oral semaglutide 14 mg, in 
      addition to metformin, for T2DM patients in the UK. METHODS: Analyses were 
      conducted from the UK healthcare payer perspective, using the IQVIA Core Diabetes 
      model, with a time horizon of 50 years. Patients received either empagliflozin or 
      oral semaglutide, in addition to metformin, until Hba1c threshold of 7.5% 
      (58 mmol/mol) was exceeded, following which treatment intensification with 
      insulin glargine in addition to empagliflozin or oral semaglutide plus metformin 
      was assumed. Baseline cohort characteristics and 52-week treatment effects were 
      derived from the PIONEER 2 trial. Treatment effects of empagliflozin and GLP-1 
      receptor agonists on hospitalisation for heart failure (hHF) were based on the 
      Empagliflozin Comparative Effectiveness and Safety (EMPRISE) real-world study. 
      Utilities, treatment costs and costs of diabetes-related complications were 
      obtained from published sources. RESULTS: Direct costs for empagliflozin plus 
      metformin were considerably lower than those for oral semaglutide plus metformin 
      (by more than GBP 6000). Compared with oral semaglutide plus metformin, 
      empagliflozin plus metformin was a cost-effective treatment for T2DM patients in 
      all scenarios tested. Probabilistic sensitivity analysis showed 
      cost-effectiveness in > 95% of the iterations using a threshold of 20,000 
      GBP/QALY. CONCLUSION: Empagliflozin 25 mg is a cost-effective treatment option 
      versus oral semaglutide 14 mg, when used in addition to metformin, for the 
      treatment of T2DM patients in the UK.
FAU - Ramos, Mafalda
AU  - Ramos M
AD  - Global HEOR/Real World Solutions, IQVIA, 2740-266, Porto Salvo, Portugal.
FAU - Cummings, Michael H
AU  - Cummings MH
AD  - Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital, 
      Portsmouth, PO6 3LY, Hampshire, UK.
FAU - Ustyugova, Anastasia
AU  - Ustyugova A
AD  - Boehringer Ingelheim International GmbH, 55216, Ingelheim Am Rhein, Germany.
FAU - Raza, Syed I
AU  - Raza SI
AD  - Boehringer Ingelheim Ltd., Bracknell, RG12 8YS, Berkshire, UK.
FAU - de Silva, Shamika U
AU  - de Silva SU
AD  - Boehringer Ingelheim Ltd., Bracknell, RG12 8YS, Berkshire, UK.
FAU - Lamotte, Mark
AU  - Lamotte M
AD  - Global HEOR/Real World Solutions, IQVIA, 1930, Zaventem, Belgium. 
      Mark.lamotte@iqvia.com.
LA  - eng
PT  - Journal Article
DEP - 20200722
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC7434815
OTO - NOTNLM
OT  - Cost-effectiveness
OT  - Costs and cost analysis
OT  - Diabetes mellitus
OT  - Empagliflozin
OT  - GLP-1 receptor agonists
OT  - Oral semaglutide
OT  - SGLT-2 inhibitors
OT  - Treatment intensification
OT  - United Kingdom
EDAT- 2020/07/24 06:00
MHDA- 2020/07/24 06:01
PMCR- 2020/07/22
CRDT- 2020/07/24 06:00
PHST- 2020/06/05 00:00 [received]
PHST- 2020/07/24 06:00 [pubmed]
PHST- 2020/07/24 06:01 [medline]
PHST- 2020/07/24 06:00 [entrez]
PHST- 2020/07/22 00:00 [pmc-release]
AID - 10.1007/s13300-020-00883-1 [pii]
AID - 883 [pii]
AID - 10.1007/s13300-020-00883-1 [doi]
PST - ppublish
SO  - Diabetes Ther. 2020 Sep;11(9):2041-2055. doi: 10.1007/s13300-020-00883-1. Epub 
      2020 Jul 22.