Diabetes, obesity & metabolism 2017 01 26() doi 10.1111/dom.12890
Glucagon-like peptide-1 (GLP-1) receptor agonists represent an attractive treatment option for patients with type 2 diabetes mellitus as they are associated with improved glycemic control, weight loss and low risk of hypoglycemia. The present analysis aimed to compare the cost-effectiveness of two GLP-1 receptor agonists, liraglutide 1.8 mg and lixisenatide 20 µg, in the UK setting based on the LIRA-LIXI(TM) trial (NCT01973231).
MATERIALS AND METHODS
Projections of costs (in 2015 pound sterling [GBP]) and clinical outcomes were made over patient lifetimes using the IMS CORE Diabetes Model. The baseline cohort and treatment effects applied on initiation of GLP-1 receptor agonists were taken from the LIRA-LIXI(TM) trial. Future costs and clinical benefits were discounted at 3.5% annually.
Liraglutide 1.8 mg was associated with improved discounted quality-adjusted life expectancy (8.87 versus 8.76 quality-adjusted life years [QALYs]) versus lixisenatide 20 µg. A greater reduction in HbA1c with liraglutide 1.8 mg led to fewer diabetes-related complications and delayed their time of onset. Liraglutide 1.8 mg was associated with increased total costs (GBP 37,153 versus GBP 36,174), driven by higher acquisition costs, but this was partially offset by savings from diabetes-related complications avoided (GBP 26,969 versus GBP 27,912). Liraglutide 1.8 mg was associated with an incremental cost-effectiveness ratio of GBP 8,901 per QALY gained versus lixisenatide 20 µg.
Long-term projections suggest that treatment of patients with type 2 diabetes with liraglutide 1.8 mg is likely to be considered highly cost-effective compared with lixisenatide 20 µg treatment in the UK setting.