Cost-utility analysis of 5 kinds of GLP-1RAs in the treatment of poorly controlled type 2 diabetes mellitus treated with metformin

XIE Zeyu; LI Mengting; HU Jia; CHEN Jisheng

doi:10.6039/j.issn.1001-0408.2024.06.14

您当前的位置：

首页 >

文章列表页 >

Cost-utility analysis of 5 kinds of GLP-1RAs in the treatment of poorly controlled type 2 diabetes mellitus treated with metformin

更新时间：2024-04-09

- Cost-utility analysis of 5 kinds of GLP-1RAs in the treatment of poorly controlled type 2 diabetes mellitus treated with metformin
- ZHONGGUO YAOFANG Vol. 35, Issue 6, Pages: 718-723(2024)
- 作者机构：
  
  广东药科大学附属第一医院临床药学重点专科，广州　510030
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2024.06.14
  CLC： R956
- Published：30 March 2024，
  
  Received：09 November 2023，
  
  Revised：04 March 2024，
扫描看全文
谢泽宇,李梦婷,胡佳等.5种GLP-1RAs治疗二甲双胍控制不佳的2型糖尿病的成本-效用分析 ^Δ[J].中国药房,2024,35(06):718-723.

XIE Zeyu,LI Mengting,HU Jia,et al.Cost-utility analysis of 5 kinds of GLP-1RAs in the treatment of poorly controlled type 2 diabetes mellitus treated with metformin[J].ZHONGGUO YAOFANG,2024,35(06):718-723.
谢泽宇,李梦婷,胡佳等.5种GLP-1RAs治疗二甲双胍控制不佳的2型糖尿病的成本-效用分析 ^Δ[J].中国药房,2024,35(06):718-723. DOI： 10.6039/j.issn.1001-0408.2024.06.14.

XIE Zeyu,LI Mengting,HU Jia,et al.Cost-utility analysis of 5 kinds of GLP-1RAs in the treatment of poorly controlled type 2 diabetes mellitus treated with metformin[J].ZHONGGUO YAOFANG,2024,35(06):718-723. DOI： 10.6039/j.issn.1001-0408.2024.06.14.

摘要

目的

评估5种胰高血糖素样肽-1受体激动剂（GLP-1RAs）治疗二甲双胍控制血糖不佳的2型糖尿病（T2DM）的长期经济性。

方法

提取既往发表的荟萃分析及其纳入的随机对照研究（RCT）中患者的基线数据，使用英国前瞻性糖尿病研究结果模型2.1预测各组患者的生存情况、长期疗效和成本，采用成本-效用分析法比较5种GLP-1RAs（利拉鲁肽、利司那肽、艾塞那肽、度拉糖肽和司美格鲁肽）的经济性；采用敏感性分析和情境分析验证基础分析结果的稳定性。

结果

共纳入21项RCT，6 796名患者。生存曲线表明，司美格鲁肽在降低因心血管疾病死亡风险上、度拉糖肽在降低全因死亡风险上较其他GLP-1RAs具有优势。成本-效用分析结果显示，5种方案的经济性从优到劣排序依次为利司那肽、司美格鲁肽、艾塞那肽、度拉糖肽和利拉鲁肽。单因素敏感性分析和概率敏感性分析表明基础分析结果稳健。情境分析结果显示，司美格鲁肽的价格至少降低54.64%，降至369.21元，其对比利司那肽才具有经济性。

结论

对于使用二甲双胍治疗后血糖控制不佳的我国T2DM患者，临床可考虑优先选择利司那肽和司美格鲁肽。

Abstract

OBJECTIVE

To assess the long-term cost-effectiveness of five glucagon-like peptide-1 receptor agonists （GLP-1RAs） in the treatment of poorly controlled type 2 diabetes mellitus （T2DM） treated with metformin.

METHODS

Baseline data from patients in previously published meta-analysis and included randomized controlled trials （RCTs） were extracted to predict survival， long-term efficacy， and costs for each group using the United Kingdom prospective diabetes study outcome model 2.1. The cost-effectiveness of 5 GLP-1RAs （liraglutide， lixisenatide， exenatide， dulaglutide， and semaglutide） was analyzed by cost-utility analysis. Sensitivity analysis and scenario analysis were also performed to verify the uncertainty of basic analysis results.

RESULTS

A total of 21 RCTs with 6 796 patients were included. Survival analysis curves showed the superiority of semaglutide in reducing the risk of death from cardiovascular disease and dulaglutide in reducing the risk of all-cause mortality over other GLP-1RAs. The cost-utility analysis showed that the five drugs were economically superior to inferior in the order of lixisenatide， semaglutide， exenatide， dulaglutide， and liraglutide； one-way and probabilistic sensitivity analyses indicated that the results were robust. The scenario analysis results indicated that the price of semaglutide should decrease by at least 54.64% to 369.21 yuan， which is cost-effectiveness compared to lixisenatide.

CONCLUSIONS

For T2DM patients in China with poor glycemic control after treatment with metformin， lixisenatide and semaglutide may be considered as the preferred regimen.

关键词

胰高血糖素样肽-1受体激动剂利司那肽司美格鲁肽艾塞那肽度拉糖肽利拉鲁肽成本-效用分析2型糖尿病

Keywords

lixisenatidesemaglutideexenatidedulaglutideliraglutidecost-utility analysistype 2 diabetes mellitus

references

American Diabetes Association. Economic costs of diabetes in the U.S. in 2017[J]. Diabetes Care，2018，41（5）：917-928.

WANG L，PENG W，ZHAO Z，et al. Prevalence and treatment of diabetes in China，2013-2018[J]. JAMA，2021，326（24）：2498-2506.

LIU J L，LIU M，CHAI Z L，et al. Projected rapid growth in diabetes disease burden and economic burden in China：a spatio-temporal study from 2020 to 2030[J]. Lancet Reg Health West Pac，2023，33：100700.

《中国老年型糖尿病防治临床指南》编写组. 中国老年2型糖尿病防治临床指南：2022年版[J]. 中国糖尿病杂志，2022，30（1）：2-51.

Writing Group of Clinical Guidelines for the Prevention and Treatment of Type 2 Diabetes in the Elderly in China. Clinical guidelines for the prevention and treatment of type 2 diabetes in the elderly in China：2022 edition[J]. Chin J Diabetes，2022，30（1）：2-51.

WANG L M，GAO P，ZHANG M，et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013[J]. JAMA，2017，317（24）：2515-2523.

ALI M K，BULLARD K M，SAYDAH S，et al. Cardiovascular and renal burdens of prediabetes in the USA：analysis of data from serial cross-sectional surveys，1988-2014[J]. Lancet Diabetes Endocrinol，2018，6（5）：392-403.

PAN Y S，CHEN W Q，WANG Y J. Prediabetes and outcome of ischemic stroke or transient ischemic attack：a systematic review and meta-analysis[J]. J Stroke Cerebrovasc Dis，2019，28（3）：683-692.

HUANG Y L，CAI X Y，MAI W Y，et al. Association between prediabetes and risk of cardiovascular disease and all cause mortality：systematic review and meta-analysis[J]. BMJ，2016，355：i5953.

MOSENZON O，ALGUWAIHES A，LEON J L A，et al. CAPTURE：a multinational，cross-sectional study of cardiovascular disease prevalence in adults with type 2 diabetes across 13 countries[J]. Cardiovasc Diabetol，2021，20（1）：154.

中华医学会糖尿病学分会. 中国2型糖尿病防治指南：2020年版[J]. 国际内分泌代谢杂志，2021，41（5）：482-548.

Chinese Medical Association，Diabetes Branch.Guideline for the prevention and treatment of type 2 diabetes mellitus in China：2020 edition[J]. Int J Endocrinol Metab，2021，41（5）：482-548.

American Diabetes Association. Introduction：standards of medical care in diabetes：2022[J]. Diabetes Care，2022，45（Suppl 1）：S1-S2.

XIE Z Y，HU J，GU H Y，et al. Comparison of the efficacy and safety of 10 glucagon-like peptide-1 receptor agonists as add-on to metformin in patients with type 2 diabetes：a systematic review[J]. Front Endocrinol，2023，14：1244432.

HAYES A J，LEAL J，GRAY A M，et al. UKPDS outcomes model 2：a new version of a model to simulate lifetime health outcomes of patients with type 2 diabetes mellitus using data from the 30-year United Kingdom Prospective Diabetes Study：UKPDS 82[J]. Diabetologia，2013，56（9）：1925-1933.

World Health Organization. The world health report 2002[J]. Midwifery，2003，19（1）：72-73.

GAO L，ZHAO F L，LI S C. Cost-utility analysis of liraglutide versus glimepiride as add-on to metformin in type 2 diabetes patients in China[J]. Int J Technol Assess Health Care，2012，28（4）：436-444.

BERTRAM M Y，LAUER J A，DE JONCHEERE K，et al. Cost-effectiveness thresholds：pros and cons[J]. Bull World Health Organ，2016，94（12）：925-930.

LI X，XU Z R，JI L N，et al. Direct medical costs for patients with type 2 diabetes in 16 tertiary hospitals in urban China：a multicenter prospective cohort study[J]. J Diabetes Investig，2019，10（2）：539-551.

SU W，LI C Y，ZHANG L，et al. Meta-analysis and cost-effectiveness analysis of insulin glargine 100 U/mL versus insulin degludec for the treatment of type 2 diabetes in China[J]. Diabetes Ther，2019，10（5）：1969-1984.

DENG J，GU S Y，SHAO H，et al. Cost-effectiveness analysis of exenatide twice daily（bid）vs insulin glargine once daily（qd）as add-on therapy in Chinese patients with type 2 diabetes mellitus inadequately controlled by oral therapies[J]. J Med Econ，2015，18（11）：974-989.

CAI X L，SHI L Z，YANG W J，et al. Cost-effectiveness analysis of dapagliflozin treatment versus metformin treatment in Chinese population with type 2 diabetes[J]. J Med Econ，2019，22（4）：336-343.

HOU X Y，WAN X，WU B. Cost-effectiveness of canagliflozin versus dapagliflozin added to metformin in patients with type 2 diabetes in China[J]. Front Pharmacol，2019，10：480.

WU B，WAN X，MA J. Cost-effectiveness of prevention and management of diabetic foot ulcer and amputation in a health resource-limited setting[J]. J Diabetes，2018，10（4）：320-327.

PAN C W，SUN H P，ZHOU H J，et al. Valuing health-related quality of life in type 2 diabetes patients in China[J]. Med Decis Making，2016，36（2）：234-241.

CURRIE C J，MCEWAN P，PETERS J R，et al. The routine collation of health outcomes data from hospital treated subjects in the Health Outcomes Data Repository（HODaR）：descriptive analysis from the first 20 000 subjects[J]. Value Health，2005，8（5）：581-590.

CLARKE P，GRAY A，HOLMAN R. Estimating utility values for health states of type 2 diabetic patients using the EQ-5D（UKPDS 62）[J]. Med Decis Making，2002，22（4）：340-349.

姚嘉奇，管欣，张瑶，等. 药物经济学概率敏感性分析中关联参数的处理与实践探讨[J]. 中国药物评价，2019，36（2）：150-155.

YAO J Q，GUAN X，ZHANG Y，et al. Discussion and practice of correlating parameters in sensitivity analysis of pharmacoeconomics[J]. Chin J Drug Eval，2019，36（2）：150-155.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Excavation of adverse event signals of dipeptidyl deptidase-4 inhibitors based on FAERS

格列美脲与格列本脲对2型糖尿病患者颈动脉粥样硬化的影响

磺脲类降糖药物长期应用的安全性研究

全球抗糖尿病药物研发现状及市场分析Δ

维格列汀对新诊断超重2型糖尿病患者炎症因子的影响研究

Related Author

ZHANG Ke

SHAO Jia

SUN Xuan

LI Bo

SONG Yin

LI ZhengXiang

叶冠龙杨羽田

汪天明陈光亮

Related Institution

Dept. of Pharmacy， Tianjin Medical College General Hospital

Dept. of Pharmacy， Tianjin First Central Hospital

Address：8/F,129 Daping Main Street,Yuzhong District,Chongqing 400042,P.R.China
Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号公网安备50010302001817
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰