title: Evaluation of the long-term cost-effectiveness of liraglutide therapy for patients with type 2 diabetes in France.
abstract: OBJECTIVE
  The present study aimed to compare the projected long-term clinical and cost implications associated with liraglutide, sitagliptin and glimepiride in patients with type 2 diabetes mellitus failing to achieve glycemic control on metformin monotherapy in France.
  
  
  METHODS
  Clinical input data for the modeling analysis were taken from two randomized, controlled trials (LIRA-DPP4 and LEAD-2). Long-term (patient lifetime) projections of clinical outcomes and direct costs (2013 Euros; €) were made using a validated computer simulation model of type 2 diabetes. Costs were taken from published France-specific sources. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed.
  
  
  RESULTS
  Liraglutide was associated with an increase in quality-adjusted life expectancy of 0.25 quality-adjusted life years (QALYs) and an increase in mean direct healthcare costs of €2558 per patient compared with sitagliptin. In the comparison with glimepiride, liraglutide was associated with an increase in quality-adjusted life expectancy of 0.23 QALYs and an increase in direct costs of €4695. Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio (ICER) of €10,275 per QALY gained vs sitagliptin and €20,709 per QALY gained vs glimepiride in France.
  
  
  CONCLUSIONS
  Calculated ICERs for both comparisons fell below the commonly quoted willingness-to-pay threshold of €30,000 per QALY gained. Therefore, liraglutide is likely to be cost-effective vs sitagliptin and glimepiride from a healthcare payer perspective in France.
authors.affiliation: a a AP-HP, Bichat Hospital, Department of Diabetology-Endocrinology-Nutrition, Department Hospital University FIRE , Paris , France.|b b INSERM, UMRS 1138, Centre de Recherche des Cordeliers , Paris , France.|c c University Paris Diderot Sorbonne Paris Cité, UFR de Médecine , Paris , France.
authors.forename: Ronan
authors.initials: R
authors.lastname: Roussel
authors.affiliation: d d Department of General Practice , Pierre et Marie Curie University , Paris , France.
authors.forename: Luc
authors.initials: L
authors.lastname: Martinez
authors.affiliation: e e sa Novo Nordisk Pharma nv , Brussels , Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Vandebrouck
authors.affiliation: f f Novo Nordisk Pharmaceutique SAS , Paris , France.
authors.forename: Habiba
authors.initials: H
authors.lastname: Douik
authors.affiliation: f f Novo Nordisk Pharmaceutique SAS , Paris , France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Emiel
authors.affiliation: f f Novo Nordisk Pharmaceutique SAS , Paris , France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Guery
authors.affiliation: g g Ossian Health Economics and Communications , Basel , Switzerland.
authors.forename: Barnaby
authors.initials: B
authors.lastname: Hunt
authors.affiliation: g g Ossian Health Economics and Communications , Basel , Switzerland.
authors.forename: William J
authors.initials: WJ
authors.lastname: Valentine
mesh_terms: D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D005382:Financing, Personal; D005602:France; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics*; D000069450:Liraglutide / Q000191:economics*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data
chemical_list: D007004:Hypoglycemic Agents; D000069450:Liraglutide
keywords: Cost; Cost-effectiveness; France; Incretin therapy; Liraglutide; Type 2 diabetes mellitus