Real-World Cost-Effectiveness: Lower Cost of Treating Patients to Glycemic Goal with Liraglutide versus ExenatideReport as inadecuate

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Advances in Therapy

, Volume 31, Issue 2, pp 202–216

First Online: 30 January 2014Received: 02 December 2013DOI: 10.1007-s12325-014-0098-8

Cite this article as: DeKoven, M., Lee, W.C., Bouchard, J. et al. Adv Ther 2014 31: 202. doi:10.1007-s12325-014-0098-8


IntroductionWhile the liraglutide effect and action in diabetes LEAD-6 clinical trial compared the efficacy and safety of liraglutide once daily LIRA to exenatide twice daily EXEN in adult patients with type 2 diabetes, few studies have explored the associated per-patient costs of glycemic goal achievement of their use in a real-world clinical setting.

MethodsThis retrospective cohort study used integrated medical and pharmacy claims linked with glycated hemoglobin A1C A1C results from the IMS Patient-Centric Integrated Data Warehouse. Patients’ ≥18 years and naïve to incretin therapies during a 6-month pre-index period, with ≥1 prescription for LIRA or EXEN between January 2010 and December 2010, were included. Patients with evidence of insulin use pre- or post-index were excluded. Only patients who were persistent on their index treatment during a 180-day post-index period were included. Follow-up A1C assessments were based on available laboratory data within 45 days before or after the 6-month post-index point in time. Diabetes-related pharmacy costs over the 6-month post-index period were captured and included costs for both the index drugs and concomitant diabetes medications.

Results234 LIRA and 182 EXEN patients were identified for the analysis. The adjusted predicted diabetes-related pharmacy costs per patient over the 6-month post-index period were higher for LIRA compared to EXEN $2,002 95% confidence interval CI: $1,981, $2,023 vs. $1,799 95% CI: $1,778, $1,820; P < 0.001. However, a higher adjusted predicted percentage of patients on LIRA reached A1C < 7% goal 64.4% 95% CI: 63.5, 65.3 vs. 53.6% 95% CI: 52.6, 54.6; P < 0.05, translating into lower average diabetes-related pharmacy costs per successfully treated patient for LIRA as compared to EXEN $3,108 vs. $3,354; P < 0.0001.

ConclusionsAlthough predicted diabetes-related pharmacy costs were greater with LIRA vs. EXEN, a higher proportion of patients on LIRA achieved A1C < 7%, resulting in a lower per-patient cost of A1C goal achievement with LIRA compared to EXEN.

KeywordsCost-effectiveness Endocrinology Exenatide Glycated hemoglobin A1C goal attainment Glycemic control Liraglutide Type 2 diabetes The data related to the key study findings included in this manuscript were presented at the 16th European International Society for Pharmacoeconomics and Outcomes Research ISPOR conference in Dublin, Ireland, November 2013.

Electronic supplementary materialThe online version of this article doi:10.1007-s12325-014-0098-8 contains supplementary material, which is available to authorized users.

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Author: Mitch DeKoven - Won Chan Lee - Jonathan Bouchard - Marjan Massoudi - Jakob Langer


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