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Switching from sitagliptin to liraglutide to manage patients with type 2 diabetes in the UK: A Long-Term Cost-Effectiveness analysis.

Barnett, Anthony H and Arnoldini, Simon and Hunt, Barnaby and Subramanian, Gowri and Hoxer, Christina Stentoft (2018) Switching from sitagliptin to liraglutide to manage patients with type 2 diabetes in the UK: A Long-Term Cost-Effectiveness analysis. Diabetes, obesity & metabolism. ISSN 1463-1326. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs

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Official URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/do...

Abstract

AIMS

The recent LIRA-SWITCH trial showed that switching from sitagliptin 100 mg to liraglutide 1.8 mg led to statistically significant and clinically relevant improvements in glycated haemoglobin (HbA ) and body mass index (BMI). Based on these findings, the aim of the present study was to assess the long-term cost-effectiveness of switching from sitagliptin to liraglutide in patients with type 2 diabetes in the UK.

MATERIALS AND METHODS

The IQVIA CORE Diabetes Model Version 8.5+ was used to project costs and clinical outcomes over patients' lifetimes. Baseline cohort characteristics and treatment effects were derived from the LIRA-SWITCH trial. Future costs and clinical benefits were discounted at 3.5% annually. Costs were accounted in pounds sterling (GBP) and expressed in 2016 values. One-way and probabilistic sensitivity analyses were performed.

RESULTS

Model projections showed improved quality-adjusted life expectancy for patients with poorly controlled HbA on sitagliptin switching to liraglutide compared with continuing sitagliptin treatment (9.18 versus 9.02 quality-adjusted life years [QALYs]). Treatment switching was associated with increased overall costs (GBP 24,737 versus GBP 22,362). Higher pharmacy costs were partially offset by reduced diabetes-related complication costs in patients who switched to liraglutide. Switching to liraglutide was associated with an incremental cost-effectiveness ratio of GBP 15,423 per QALY gained versus continuing on sitagliptin treatment.

CONCLUSIONS

Switching from sitagliptin 100 mg to liraglutide 1.8 mg in patients with poor glycaemic control was projected to improved clinical outcomes and is likely to be considered cost-effective in the UK setting and therefore a good use of limited NHS resources.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
Subjects: WK Endocrine system. Endocrinology
Divisions: Ambulatory Care > Diabetes
Related URLs:
Depositing User: Mrs Semanti Chakraborty
Date Deposited: 11 May 2018 15:21
Last Modified: 11 May 2018 15:21
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1636

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