808-P: Economic Benefits of Initiating Empagliflozin vs. GLP-1 Receptor Agonists among Patients with Type 2 Diabetes

Abstract

Background: SGLT-2 inhibitors and GLP-1 receptor agonists (GLP-1RAs) have proven clinical benefit profiles, and the ADA recommends both as treatment options for T2D patients uncontrolled on metformin. There is limited research on whether these clinical benefits translate into differential cost savings. This study sought to assess the all-cause (AC) healthcare costs associated with initiating empagliflozin (EMPA) vs. GLP-1RAs among patients with T2D. Methods: A commercial US claims database was used to identify patients with T2D who newly initiated EMPA or GLP-1 RA from 08/2014-09/2018. Study cohorts (EMPA users and GLP-1RA users) were matched using propensity scores (PSs) (1:1 ratio, caliper: ± 0.05) based on baseline demographic and clinical variables. AC costs were computed on a per patient per month (PPPM) basis during a variable follow-up period of up to 12 months and compared across study cohorts using generalized linear models. A subanalysis comparing AC costs among patients who initiated second-line treatment with EMPA or GLP-1RA after metformin monotherapy was also conducted. Results: PS matching resulted in a sample of 43,588 patients (21,794 patients in each group) whose mean age was 54 years and 63% were male. The total AC PPPM costs were significantly lower for EMPA vs. GLP-1RA users ($1,450 vs. $1,723; Δ = $273; P<0.001), with both pharmacy (Δ = $195; P<0.001) and medical (Δ = $78; P=0.006) costs being significantly lower. Similar results were observed in the subanalysis where initiating EMPA after metformin monotherapy was associated with lower AC PPPM costs compared to GLP-1RA users (Δ = $271; P<0.001). Conclusion: Among patients with T2D, initiating EMPA vs. GLP-1RA was associated with lower AC healthcare costs, where the drivers were both lower medical and pharmacy costs. These findings can inform treatment selection processes that are aimed to optimize T2D management, especially from an economic perspective. Disclosure P. Pimple: Employee; Self; Boehringer Ingelheim Pharmaceuticals, Inc. A. Raju: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Takeda Pharmaceutical Company Limited, Employee; Self; Xcenda LLC, Stock/Shareholder; Self; Teva Pharmaceutical Industries Ltd. E. Farrelly: Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Takeda Pharmaceutical Company Limited, Employee; Self; Xcenda LLC. S. Shetty: Employee; Self; Boehringer Ingelheim Pharmaceuticals, Inc. Funding Boehringer Ingelheim