Analisi di costo-efficacia di exenatide versus insulina glargine nel trattamento dei pazienti diabetici di tipo 2 in fallimento secondario al doppio ipoglicemizzante orale

Abstract

The objective of this economic evaluation was to compare efficacy and costs of exenatide or insulin glargine in the treatment of patients with type 2 diabetes mellitus who have poor glycemic control despite taking oral blood glucose-lowering drugs. We built a model in which two cohorts of patients received exenatide or insulin glargine. The patients were followed for one year. The economic evaluation was conducted from the perspective of the Italian National Health Service. We considered Quality-Adjusted Life-Years (QALYs) and direct medical costs (pharmacological treatment, complications etc.). Benefits and costs were not discounted. Costs were assessed in 2007 Euros. Sensitivity and threshold analysis on key clinical and economic parameters were performed. For the two cohorts QALYs (per patient) with exenatide were 0.75 and for insulin glargine were 0.74. The expected cost (per patient) was € 2,757.37 with exenatide and € 2,837.05 with insulin glargine. This study suggests that, compared with insulin glargine, exenatide is dominant in the treatment of patients with type 2 diabetes mellitus who have poor glycemic control despite taking oral blood glucose-lowering drugs.