Treatment of type 2 diabetes with saxagliptin: a pharmacoeconomic evaluation in Argentina

• Autores: Elgart, Jorge Federico; Caporale, Joaquín E.; Gonzalez, Lorena; Aiello, Eleonora; Waschbusch, Maximiliano; Gagliardino, Juan Jose
• Año de publicación: 2013
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: Type 2 Diabetes Treatment; Saxagliptin; Dpp-4 Inhibitors; Pharmacoeconomics; Cost-Effectiveness Analysis; Latin America; Argentina
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Background: The increasing prevalence of diabetes and its inadequate management results in a heavy burden of the disease for patients, the health and the productive systems and the community. Consequently, it is necessary to have new effective drugs to treat people with diabetes to decrease such burden. DPP-4 inhibitors can help to cope with this demand, but their use is challenged by their apparently high cost. The aim of the current study was to compare a simulated cost-effectiveness ratio of metformin (MET) plus one drug of the DPP-4 inhibitors family, saxagliptin (SAXA), or sulfonylurea (SU) treatment during a 20-year period, from the perspective of the social security system, in a cohort of people with Type 2 diabetes (T2DM) who did not attain glycosylated hemoglobin treatment target values only with MET. Methods: A discrete event simulation model (Cardiff diabetes model) based on UKPDS 68 was used to simulate disease progression and to estimate the economic and health treatment consequences in people with T2DM. The clinical efficacy parameters for SAXA administration were obtained from the literature; local standard costs were considered for drug acquisition, adverse events (AEs), and micro/macrovascular complications.Costs were expressed in United States dollars (2009) with an annual 3.5% discount and a 20-year time horizon. Results: The SAXA+MET treated group had a lower number of non-fatal events than the SU+MET treated group. The model also predicted a lower number of fatal macrovascular events for the SAXA+MET group (149.6 vs. 152.8). The total cost of the SAXA+MET cohort was 15% higher than that of the SU+MET cohort. Treatment with SAXA+MET resulted in a higher number of quality-adjusted life years (QALYs) (9.54 vs. 9.32) and life-years gained (LYGs) (20.84 vs. 20.76) compared to those treated with SU+MET. The incremental cost per QALY and LYG gained was $7,374 and $20,490, respectively. Conclusions: According to the criteria proposed by the Commission on Macroeconomics and Health, the use of the combination SAXA+MET is highly cost-effective in Argentina.
Fil: Elgart, Jorge Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina
Fil: Caporale, Joaquín E.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina
Fil: Gonzalez, Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina
Fil: Aiello, Eleonora. Bristol-Myers Squibb; Argentina
Fil: Waschbusch, Maximiliano. Bristol-Myers Squibb; Argentina
Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina