title: Cost-effectiveness of saxagliptin (Onglyza®) in type 2 diabetes in Sweden.
abstract: OBJECTIVE
  The objective of this study was to investigate the cost-effectiveness of saxagliptin (Onglyza(®)), a DPP-4 inhibitor, plus metformin compared with a sulphonylurea (SU) (Glipizide) plus metformin in Swedish patients not well controlled on metformin alone.
  
  
  METHODS
  Data from a 52-week clinical trial comparing saxagliptin and glipizide in combination with metformin was used in a simulation model to estimate long term complications in a cohort of type 2 diabetes patients. The model estimates the incidence of microvascular and macrovascular complications, diabetes-specific mortality, all-cause mortality, and ultimately, costs and quality-adjusted life years (QALYs) associated with the investigated treatment strategies. Costs and QALYs were estimated for a lifetime time horizon.
  
  
  RESULTS
  Compared with SU+metformin, the cost per QALY gained with saxagliptin+metformin is approximately SEK 91,000. Patients on saxagliptin+metformin gain 0.10 QALYs on average, at an incremental cost of around SEK 9500. The cost-effectiveness results were robust to various sensitivity analyses.
  
  
  CONCLUSIONS
  This study demonstrates that, over a patient's lifetime, the addition of saxagliptin to metformin is associated with improvements in quality-adjusted life years compared with SU in patients with type 2 diabetes. Saxagliptin treatment is a cost-effective treatment alternative for type 2 diabetes in patients not well-controlled on metformin alone.
authors: Department of Health Economics, AstraZeneca Nordic, Astraallén B674, Södertälje, Sweden. ola.granstrom@astrazeneca.com
authors: Ola
authors: O
authors: Granström
authors: Klas
authors: K
authors: Bergenheim
authors: Phil
authors: P
authors: McEwan
authors: Karin
authors: K
authors: Sennfält
authors: Martin
authors: M
authors: Henriksson
mesh_terms: D000218:Adamantane / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000191:economics* / Q000401:mortality; D004151:Dipeptides / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008687:Metformin / Q000191:economics / Q000627:therapeutic use; D008875:Middle Aged; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D013453:Sulfonylurea Compounds / Q000191:economics / Q000627:therapeutic use; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000218:Adamantane; D015415:Biomarkers; D004151:Dipeptides; D054873:Dipeptidyl-Peptidase IV Inhibitors; D006442:Glycated Hemoglobin; D008687:Metformin; D013453:Sulfonylurea Compounds; C517652:hemoglobin A1c protein, human; C502994:saxagliptin