Cost-effectiveness of dapagliflozin (Forxiga®) added to metformin compared with sulfonylurea added to metformin in type 2 diabetes in the Nordic countries.
OBJECTIVE
The aim of this study was to assess the long-term cost-effectiveness of dapagliflozin (Forxiga(®)) added to metformin, compared with sulfonylurea (SU) added to metformin, in Nordic Type 2 diabetes mellitus (T2DM) patients inadequately controlled on metformin.


METHODS
Data from a 52-week clinical trial comparing dapagliflozin and SU in combination with metformin was used in a Cardiff simulation model to estimate long term diabetes-related complications in a cohort of T2DM patients. Costs and QALYs were calculated from a healthcare provider perspective and estimated over a patient's lifetime.


RESULTS
Compared with metformin+SU, the cost per QALY gained with dapagliflozin+metformin was €7944 in Denmark, €5424 in Finland, €4769 in Norway, and €6093 in Sweden. Metformin+dapagliflozin was associated with QALY gains ranging from 0.236 in Norway to 0.278 in Sweden and incremental cost ranging from €1125 in Norway to €1962 in Denmark. Results were robust across both one-way and probabilistic sensitivity analyses. Results were driven by weight changes associated with each treatment.


CONCLUSIONS
Results indicate that metformin+dapagliflozin is associated with gains in QALY compared with metformin+SU in Nordic T2DM patients inadequately controlled on metformin. Dapagliflozin treatment is a cost-effective treatment alternative for Type 2 diabetes in all four Nordic countries.
AstraZeneca, Södertälje, Sweden. Electronic address: ugne.sabale@astrazeneca.com.
Ugne
U
Sabale
AstraZeneca, Södertälje, Sweden.
Mattias
M
Ekman
AstraZeneca, Södertälje, Sweden.
Ola
O
Granström
AstraZeneca, Mölndal, Sweden.
Klas
K
Bergenheim
Health Economics and Outcomes Research Ltd., Monmouth, UK; Centre for Health Economics, Swansea University, UK.
Phil
P
McEwan
D001559:Benzhydryl Compounds / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005960:Glucosides / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D008687:Metformin / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D001559:Benzhydryl Compounds; D005960:Glucosides; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; C529054:dapagliflozin; D008687:Metformin
Cost-effectiveness; Dapagliflozin; Economic modeling; Sulfonylurea; Type 2 diabetes mellitus