Cost-utility analysis of 5 kinds of GLP-1RAs in the treatment of poorly controlled type 2 diabetes mellitus treated with metformin
- VernacularTitle:5种GLP-1RAs治疗二甲双胍控制不佳的2型糖尿病的成本-效用分析
- Author:
Zeyu XIE
1
;
Mengting LI
1
;
Jia HU
1
;
Jisheng CHEN
1
Author Information
1. Key Specialty of Clinical Pharmacy，the First Affiliated Hospital of Guangdong Pharmaceutical University，Guangzhou 510030，China
- Publication Type:Journal Article
- Keywords:
glucagon-like peptide-1 receptor agonist
- From:
China Pharmacy
2024;35(6):718-723
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To assess the long-term cost-effectiveness of five glucagon-like peptide-1 receptor agonists （GLP- 1RAs） in the treatment of poorly controlled type 2 diabetes mellitus （T2DM） treated with metformin. METHODS Baseline data from patients in previously published meta-analysis and included randomized controlled trials （RCTs） were extracted to predict survival， long-term efficacy， and costs for each group using the United Kingdom prospective diabetes study outcome model 2.1. The cost-effectiveness of 5 GLP-1RAs （liraglutide， lixisenatide， exenatide， dulaglutide， and semaglutide） was analyzed by cost- utility analysis. Sensitivity analysis and scenario analysis were also performed to verify the uncertainty of basic analysis results. RESULTS A total of 21 RCTs with 6 796 patients were included. Survival analysis curves showed the superiority of semaglutide in reducing the risk of death from cardiovascular disease and dulaglutide in reducing the risk of all-cause mortality over other GLP- 1RAs. The cost-utility analysis showed that the five drugs were economically superior to inferior in the order of lixisenatide， semaglutide， exenatide， dulaglutide， and liraglutide； one-way and probabilistic sensitivity analyses indicated that the results were robust. The scenario analysis results indicated that the price of semaglutide should decrease by at least 54.64% to 369.21 yuan， which is cost-effectiveness compared to lixisenatide. CONCLUSIONS For T2DM patients in China with poor glycemic control after treatment with metformin， lixisenatide and semaglutide may be considered as the preferred regimen.
