Abstract
ObjectiveTo estimate the long-term cost-effectiveness of dapagliflozin versus acarbose as monotherapy in treatment-naïve patients with type 2 diabetes mellitus (T2DM) in China.MethodsThe Cardiff Diabetes Model, an economic model designed to evaluate the cost-effectiveness of comparator therapies in diabetes was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews, hospital surveys, meta-analysis and indirect treatment comparison were conducted to obtain model-required patient profiles, clinical data and costs. Health insurance costs (2015¥) were estimated over 40 years from a healthcare payer perspective. Univariate and probabilistic sensitivity analyses were performed.ResultsThe model predicted that dapagliflozin had lower incidences of cardiovascular events, hypoglycemia and mortality events, was associated with a mean incremental benefit of 0.25 quality-adjusted life-years (QALYs) and with a lower cost of ¥8,439 compared with acarbose. This resulted in a cost saving of ¥33,786 per QALY gained with dapagliflozin. Sensitivity analyses determined that the results are robust.ConclusionDapagliflozin is dominant compared with acarbose as monotherapy for Chinese T2DM patients, with a little QALY gain and lower costs. Dapagliflozin offers a well-tolerated and cost-effective alternative medication for treatment-naive patients in China, and may have a direct impact in reducing the disease burden of T2DM.
Highlights
Diabetes as one of the most threatening noncommunicable diseases, imposes great health challenges and heavy disease burden on patients and healthcare systems [1]
Dapagliflozin is dominant compared with acarbose as monotherapy for Chinese type 2 diabetes mellitus (T2DM) patients, with a little quality-adjusted life-years (QALYs) gain and lower costs
The disease burden of diabetes is escalating in China, the International Diabetes Federation (IDF) reports that diabetes prevalence in people aged 20–79 years is at 10.6% in 2015 with China having the highest number of diabetics (109.6 million) worldwide [2]
Summary
Diabetes as one of the most threatening noncommunicable diseases, imposes great health challenges and heavy disease burden on patients and healthcare systems [1]. The disease burden of diabetes is escalating in China, the International Diabetes Federation (IDF) reports that diabetes prevalence in people aged 20–79 years is at 10.6% in 2015 with China having the highest number of diabetics (109.6 million) worldwide [2]. Glycaemic control remains elusive for the majority of Chinese diabetics. 25.8% of patients receive diabetes-related treatments; and only 39.7% of those treated have adequate glycaemic control [3]. Diabetes-related health expenditure in China is high (51 billion US dollars) in 2015, ranked second worldwide [2]
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