title: Cost efficiency of canagliflozin versus sitagliptin for type 2 diabetes mellitus.
abstract: OBJECTIVE
  To compare 1-year clinical outcomes and cost efficiency of treating adults with type 2 diabetes mellitus (T2DM) with canagliflozin (300 mg/day) or sitagliptin (100 mg/day), both added on a background of metformin and sulfonylurea.
  
  
  METHODS
  An economic model integrated data from an active-controlled, randomized trial, claims database analyses, and published literature.
  
  
  METHODS
  The model adopted a US managed care payer perspective and included the clinical and economic impact of achieving specific clinical quality goals. The model was run separately for 2 single clinical quality metrics, glycated hemoglobin (A1C) < 7% (used as base case) or < 8%, and 4 composite metrics (A1C < 7% or < 8% combined with body mass index < 30 kg/m2 and blood pressure < 140/90 mm Hg or low-density lipoprotein cholesterol < 100 mg/dL). Cost savings of achieving versus not achieving metrics were derived from a claims database analysis. Drug and adverse event costs were included.
  
  
  RESULTS
  In the base case, compared with sitagliptin 100 mg, treatment with canagliflozin 300 mg resulted in $215 in annual cost savings and 12.3 absolute percentage points more patients achieving goal. Similar findings were found across all other quality metrics (difference in proportion achieving goal ranging from 6.7% to 19.0% and annual savings ranging from $1 to $669). Canagliflozin remained cost saving versus sitagliptin in sensitivity analyses.
  
  
  CONCLUSIONS
  Canagliflozin 300 mg may represent a cost-efficient T2DM treatment option versus sitagliptin 100 mg for patients on metformin plus sulfonylurea due to lower overall costs and better achievement of A1C and quality composite goals.
authors.forename: Varun U
authors.initials: VU
authors.lastname: Ektare
authors.forename: Janice M S
authors.initials: JM
authors.lastname: Lopez
authors.forename: Silas C
authors.initials: SC
authors.lastname: Martin
authors.forename: Dipen A
authors.initials: DA
authors.lastname: Patel
authors.forename: Marcia F T
authors.initials: MF
authors.lastname: Rupnow
authors.affiliation: 4350 E W Highway, Ste 430, Bethesda, MD 20814. E-mail: mbotteman@pharmerit .com.
authors.forename: Marc F
authors.initials: MF
authors.lastname: Botteman
mesh_terms: D000328:Adult; D000068896:Canagliflozin / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics; D016527:Drug Costs; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D017048:Health Care Costs; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D018803:Models, Economic; D000068900:Sitagliptin Phosphate / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000068896:Canagliflozin; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000068900:Sitagliptin Phosphate; C517652:hemoglobin A1c protein, human