title: Cost-effectiveness of intermediate or long-acting insulin versus Exenatide in type 2 diabetes mellitus patients not optimally controlled on dual oral diabetes medications.
abstract: OBJECTIVE
  To better understand exenatide's role in the treatment of type 2 diabetes, this analysis assessed its cost-effectiveness in comparison to an intermediate (NPH) and long-acting insulin (glargine). Exenatide is a recently approved medication for the treatment of type 2 diabetes for use in addition to frequently used oral diabetes medications.
  
  
  METHODS
  Two studies were identified by a Medline search (1996-Oct 2005) that were similar in study duration, baseline glycemic control, population size, and primary outcomes to appropriately assess the cost-effectiveness of either insulin in comparison to exenatide on both glycemic and weight control.
  
  
  RESULTS
  Both NPH and glargine appear to be more cost effective than exenatide with respect to glycemic control (incremental CE ratios -1,968 and - 65,520 respectively). Exenatide appears to be more cost effective for reductions in body weight than either NPH (CE ratio 235) or glargine (CE ratio 128).
  
  
  CONCLUSIONS
  Compared to intermediate and long-acting insulin therapies, exenatide does not appear to be as cost effective for the treatment of type 2 diabetes.
authors.affiliation: Assistant Professor. Department of Pharmacy Practice and Veterans Administration North Texas Health Care System. School of Pharmacy Texas Tech University Health Sciences Center. Dallas, TX ( USA ).
authors.forename: Krystal L
authors.initials: KL
authors.lastname: Edwards
authors.affiliation: Division Head - Primary Care. Assistant Professor. Department of Pharmacy Practice, School of Pharmacy. Texas Tech University Health Sciences Center. Dallas, TX ( USA ).
authors.forename: Brian K
authors.initials: BK
authors.lastname: Irons
authors.affiliation: Department of Family and Community Medicine, School of Medicine. Texas Tech University Health Sciences Center. Dallas, TX ( USA ).
authors.forename: Tom
authors.initials: T
authors.lastname: Xu
keywords: Cost-Benefit Analysis; Diabetes; Exenatide; Glargine; Insulin; Insulin Isophane