title: Cost-utility analysis of liraglutide versus glimepiride as add-on to metformin in type 2 diabetes patients in China.
abstract: OBJECTIVE
  The aim of this study was to evaluate the long-term cost-utility of liraglutide versus glimepiride as add-on therapy to metformin in patients with type 2 diabetes mellitus (T2DM), based on the results of clinical trial conducted in Asian population.
  
  
  METHODS
  The validated UKPDS Outcomes Model was used to project life expectancy, quality adjusted life-years (QALYs), incidence of diabetes-related complication and cost of complications in patients receiving those regimens. Baseline cohort characteristics and treatment effects were derived from an Asian study. China-specific complication costs and utility score were taken from local studies. Patients' outcomes were modeled for 30 years and incremental cost-effectiveness ratios were calculated for liraglutide compared with glimepiride from the healthcare system perspective. Both future costs and clinical benefits were discounted at 3 percent. Sensitivity analyses were performed.
  
  
  RESULTS
  Over a period of 30 years, compared with glimepiride, liraglutide 1.8 mg was associated with improvements in life expectancy (0.1 year) and quality adjusted life-year (0.168 QALY), and a reduced incidence of diabetes-related complications leading to an incremental cost-effectiveness ratio per QALY gained versus glimepiride of CNY 25,6871 (DEC 2010, 1 USD = 6.6227 CNY).
  
  
  CONCLUSIONS
  Long-term projections indicated that liraglutide was associated with increased life expectancy, QALYs, and reduced complication incidences comparing with glimepiride. When the UK cost of liraglutide was discounted by 38 percent, liraglutide would be a cost-effective option in China from the healthcare system perspective using the 3X GDP/capita per QALY as the WTP threshold.
authors.affiliation: School of Biomedical Sciences & Pharmacy, University of Newcastle, Australia.
authors.forename: Lan
authors.initials: L
authors.lastname: Gao
authors.forename: Fei-Li
authors.initials: FL
authors.lastname: Zhao
authors.forename: Shu-Chuen
authors.initials: SC
authors.lastname: Li
mesh_terms: D002681:China; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics; D004359:Drug Therapy, Combination; D052216:Glucagon-Like Peptide 1 / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D017048:Health Care Costs; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use*; D008017:Life Expectancy; D000069450:Liraglutide; D008687:Metformin / Q000191:economics / Q000627:therapeutic use*; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D013453:Sulfonylurea Compounds / Q000191:economics / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; C057619:glimepiride; D000069450:Liraglutide; D052216:Glucagon-Like Peptide 1; D008687:Metformin