title: [Cost-effectiveness of exenatide versus insulin glargine in Spanish patients with obesity and type 2 diabetes mellitus].
abstract: OBJECTIVE
  Exenatide, a GLP-1 receptor agonist for adjuvant treatment of type 2 diabetes mellitus (T2DM), has been shown to be as effective as insulin glargine (IG) for reducing glycated hemoglobin levels combined with metformin or/and sulphonylureas. Exenatide is associated to weight reduction and a higher incidence of gastrointestinal adverse events. The objective of this study was to assess the cost-effectiveness of exenatide as compared to IG in obese patients with T2DM not achieving an adequate blood glucose control from the perspective of the Spanish healthcare system.
  
  
  METHODS
  Pharmacoeconomic model inputs were obtained from an obese subpopulation (BMI ≥ 30 k/m(2)) of an international, randomized, controlled clinical trial comparing exenatide with IG in poorly controlled T2DM patients, and were supplemented with country-specific data.
  
  
  RESULTS
  Exenatide was associated to improvements in life-years gained and quality-adjusted life years (QALYs) by 0.11 and 0.62 respectively versus IG. Direct costs were € 9,306 higher as compared to IG (€ 47,010 versus € 37,704, with increased pharmacy costs as the main driver). Exenatideís incremental cost-effectiveness ratio was € 15,068 per QALY gained versus IG.
  
  
  CONCLUSIONS
  Exenatide was associated to greater clinical benefits and higher costs in obese T2DM patients as compared to IG. Considering a willingness-to-pay threshold of € 30,000 per QALY gained in the Spanish setting, exenatide represents an efficient option in comparison with IG.
authors: IMS Health, Basilea, Suiza.
authors: Gordon
authors: G
authors: Goodall
authors: María
authors: M
authors: Costi
authors: Louise
authors: L
authors: Timlin
authors: Jesús
authors: J
authors: Reviriego
authors: José Antonio
authors: JA
authors: Sacristán
authors: Jayne
authors: J
authors: Smith-Palmer
authors: Tatiana
authors: T
authors: Dilla
mesh_terms: D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D000077270:Exenatide; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use*; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010455:Peptides / Q000191:economics* / Q000627:therapeutic use*; D014688:Venoms / Q000191:economics* / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D010455:Peptides; D014688:Venoms; D000069036:Insulin Glargine; D000077270:Exenatide