Cost-Effectiveness of Dapagliflozin versus Acarbose as a Monotherapy in Type 2 Diabetes in China.
OBJECTIVE
To estimate the long-term cost-effectiveness of dapagliflozin versus acarbose as monotherapy in treatment-naïve patients with type 2 diabetes mellitus (T2DM) in China.


METHODS
The Cardiff Diabetes Model, an economic model designed to evaluate the cost-effectiveness of comparator therapies in diabetes was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews, hospital surveys, meta-analysis and indirect treatment comparison were conducted to obtain model-required patient profiles, clinical data and costs. Health insurance costs (2015¥) were estimated over 40 years from a healthcare payer perspective. Univariate and probabilistic sensitivity analyses were performed.


RESULTS
The model predicted that dapagliflozin had lower incidences of cardiovascular events, hypoglycemia and mortality events, was associated with a mean incremental benefit of 0.25 quality-adjusted life-years (QALYs) and with a lower cost of ¥8,439 compared with acarbose. This resulted in a cost saving of ¥33,786 per QALY gained with dapagliflozin. Sensitivity analyses determined that the results are robust.


CONCLUSIONS
Dapagliflozin is dominant compared with acarbose as monotherapy for Chinese T2DM patients, with a little QALY gain and lower costs. Dapagliflozin offers a well-tolerated and cost-effective alternative medication for treatment-naive patients in China, and may have a direct impact in reducing the disease burden of T2DM.
Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang, China.
Shuyan
S
Gu
Department of Endocrinology and Metabolism, Chinese PLA General Hospital, Chinese PLA Medical College, Beijing, China.
Yiming
Y
Mu
Department of Pharmacy, Peking University Third Hospital, Beijing, China.
Suodi
S
Zhai
Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang, China.
Yuhang
Y
Zeng
Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang, China.
Xuemei
X
Zhen
Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang, China.
Hengjin
H
Dong
D020909:Acarbose / Q000008:administration & dosage / Q000191:economics*; D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000191:economics*; D002681:China; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D005960:Glucosides / Q000008:administration & dosage / Q000191:economics*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000191:economics*; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D016896:Treatment Outcome
D001559:Benzhydryl Compounds; D005960:Glucosides; D007004:Hypoglycemic Agents; C529054:dapagliflozin; D020909:Acarbose