A new angle for glp-1 receptor agonist: the medical economics argument. Editorial on: Huetson P, Palmer JL, Levorsen A, et al. Cost-effectiveness of the once-daily glp-1 receptor agonist lixisenatide compared to bolus insulin both in combination with basal insulin for the treatment of patients with type 2 diabetes in Norway. J Med Econ 2015: 1-13 [Epub ahead of print].
Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are relatively new medications for diabetes that offer a weight-loss profile that can be considered desirable for patients with both type 2 diabetes (T2D) and obesity. GLP-1 RA are effective in combination with insulin, and even slightly superior or at least equal to short-acting insulin in T2D; however, since they work in the incretin system, they may not be effective in long-standing disease. Additionally, only recently have publications reported their cardiovascular safety, and there is limited evidence for long-term effectiveness. The work presented by Huetson et al. offers a much needed perspective through a medical economic model for the long term cost-effectiveness of GLP-1 RA. The authors found benefits in quality-adjusted life years and reduced lifetime healthcare costs. While there are a few limitations, this study contributes to the understanding of these agents and their impact on the epidemics of obesity in T2D, where weight management is no longer an option, but an essential component of the diabetes plan of care.
a a ABIM Internal Medicine, Geriatric Medicine, Endocrinology, Diabetes & Metabolism, Geriatrics Research, Education and Clinical Center (GRECC), Metabolic Clinic Director, Miami VA Medical Center , Miami , FL , USA.|b b Division of Epidemiology, Division of Geriatric Medicine , University of Miami Miller School of Medicine , Miami , FL , USA.
Willy Marcos
WM
Valencia
c c ABIM Geriatric Medicine, Endocrinology, Diabetes & Metabolism, GRECC Director, Miami VA Healthcare System , Miami , FL , USA.|d d Division of Epidemiology Chief, Division of Geriatric Medicine Interim Chief , University of Miami Miller School of Medicine , Miami , FL , USA.
Hermes Jose
HJ
Florez
D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004470:Economics, Medical; D052216:Glucagon-Like Peptide 1 / Q000627:therapeutic use; D000067757:Glucagon-Like Peptide-1 Receptor; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics; D007328:Insulin / Q000627:therapeutic use*; D018027:Receptors, Glucagon
D000067757:Glucagon-Like Peptide-1 Receptor; D007004:Hypoglycemic Agents; D007328:Insulin; D018027:Receptors, Glucagon; D052216:Glucagon-Like Peptide 1
Economic model; Glucagon-like peptide-1 receptor agonists; Obesity; Type 2 diabetes