title: Cost-effectiveness analysis of liraglutide versus sitagliptin or exenatide in patients with inadequately controlled Type 2 diabetes on oral antidiabetic drugs in Greece.
abstract: BACKGROUND
  To evaluate the long-term cost-effectiveness of liraglutide versus sitagliptin or exenatide, added to oral antidiabetic drug mono- or combination therapy respectively, in patients with Type 2 diabetes in Greece.
  
  
  METHODS
  The CORE Diabetes Model, a validated computer simulation model, was adapted to the Greek healthcare setting. Patient and intervention effects data were gathered from a clinical trial comparing liraglutide 1.2 mg once daily vs. sitagliptin 100 mg once daily, both combined with metformin, and a clinical trial comparing liraglutide 1.8 mg once daily vs. exenatide 10 μg twice daily, both as add-on to metformin, glimepiride or both. Direct costs were reported in 2013 Euros and calculated based on published and local sources. All future outcomes were discounted at 3.5% per annum, and the analysis was conducted from the perspective of a third-party payer in Greece.
  
  
  RESULTS
  Over a patient's lifetime, treatment with liraglutide 1.2 mg vs. sitagliptin drove a mean increase in discounted life expectancy of 0.13 (SD 0.23) years and in discounted quality-adjusted life expectancy of 0.19 (0.16) quality-adjusted life years (QALYs), whereas therapy with liraglutide 1.8 mg vs. exenatide yielded increases of 0.14 (0.23) years and 0.19 (0.16) QALYs respectively. As regards lifetime direct costs, liraglutide 1.2 mg resulted in greater costs of €2797 (€1468) versus sitagliptin, and so did liraglutide 1.8 mg compared with exenatide (€1302 [€1492]). Liraglutide 1.2 and 1.8 mg doses were associated with incremental cost effectiveness ratios of €15101 and €6818 per QALY gained, respectively.
  
  
  CONCLUSIONS
  Liraglutide is likely to be a cost-effective option for the treatment of Type 2 diabetes in a Greek setting.
authors.affiliation: Department of Health Services Organisation and Management, National School of Public Health, 196 Alexandras Avenue, 11521 Athens, Greece. tzanet.haris@gmail.com.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Tzanetakos
authors.forename: Andreas
authors.initials: A
authors.lastname: Melidonis
authors.forename: Christos
authors.initials: C
authors.lastname: Verras
authors.forename: Georgia
authors.initials: G
authors.lastname: Kourlaba
authors.forename: Nikos
authors.initials: N
authors.lastname: Maniadakis
mesh_terms: D000328:Adult; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics; D000077270:Exenatide; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics; D006115:Greece; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000191:economics*; D000069450:Liraglutide; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000008:administration & dosage / Q000191:economics*; D011719:Pyrazines / Q000008:administration & dosage / Q000191:economics*; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000008:administration & dosage / Q000191:economics*; D014688:Venoms / Q000008:administration & dosage / Q000191:economics*
chemical_list: D007004:Hypoglycemic Agents; D010455:Peptides; D011719:Pyrazines; D014230:Triazoles; D014688:Venoms; D000069450:Liraglutide; D052216:Glucagon-Like Peptide 1; D000077270:Exenatide; D000068900:Sitagliptin Phosphate