Value of GLP-1 receptor agonists versus long-acting insulins for type 2 diabetes patients with and without established cardiovascular or chronic kidney diseases: A model-based cost-effectiveness analysis using real-world data. (April 2023)

• Record Type: Journal Article
• Authors: Yang, Chun-Ting; Yao, Wen-Yu; Ou, Huang-Tz; Kuo, Shihchen
• Is Part Of: Diabetes research and clinical practice. Volume 198(2023)
• Publication Date: 2023-04
• Subjects: GLP-1 receptor agonist -- Long-acting insulin -- Cost-effectiveness analysis -- Cardiovascular disease -- Chronic kidney disease; GLP-1RAs glucagon-like peptide-1 receptor agonists -- T2D type 2 diabetes -- GLA glucose-lowering agent -- LAIs long-acting insulins -- CEA cost-effectiveness analysis -- CVD cardiovascular disease -- CKD chronic kidney disease -- MI myocardial infarction -- HF heart failure -- NHIRD National Health Insurance Research Database -- QALY quality-adjusted life-year -- NHI National Health Insurance -- USD United States dollars -- ICER incremental cost-effectiveness ratio -- WTP willingness-to-pay -- PSA probabilistic sensitivity analysis; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2023.110625
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: To evaluate the cost-effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1RAs) versus long-acting insulins (LAIs) in patients with type 2 diabetes (T2D) using real-world data. Methods: A Markov model was utilized to estimate healthcare costs (US$) and quality-adjusted life-years (QALYs) of receiving treatments over 10 years from the healthcare sector perspective. Model inputs were derived from the analyses of Taiwan's National Health Insurance Research Database or published literature on Taiwanese T2D populations. Base-case analysis was performed for the overall study cohort and subgroup analyses were stratified by the presence or absence of established cardiovascular diseases (CVDs) or chronic kidney diseases (CKDs). Results: Overall, using GLP-1RAs versus LAIs cost $6, 053 per QALY gained. Results were robust across sensitivity and scenario analyses. Among patients with established CVDs and CKDs, GLP-1RA versus LAI therapy saved $673 (cost-saving) and cost $1, 675 per QALY gained, respectively. Among patients without established CVDs and CKDs, GLP-1RA versus LAI therapy cost $9, 093 and $7, 659 per QALY gained, respectively. Conclusions: Using GLP-1RAs versus LAIs for T2D patients represented good economic value in real-world practice. Pronounced economic benefits of GLP-1RA therapy among those with prior CVDs or CKDs support rational treatment decisions and optimal healthcare resource allocation for these patients.