title: Cost-Effectiveness of Saxagliptin versus Acarbose as Second-Line Therapy in Type 2 Diabetes in China.
abstract: OBJECTIVE
  This study assessed the long-term cost-effectiveness of saxagliptin+metformin (SAXA+MET) versus acarbose+metformin (ACAR+MET) in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled on MET alone.
  
  
  METHODS
  Systematic literature reviews were performed to identify studies directly comparing SAXA+MET versus ACAR+MET, and to obtain diabetes-related events costs which were modified by hospital surveys. A Cardiff Diabetes Model was used to estimate the long-term economic and health treatment consequences in patients with T2DM. Costs (2014 Chinese yuan) were calculated from the payer's perspective and estimated over a patient's lifetime.
  
  
  RESULTS
  SAXA+MET predicted lower incidences of most cardiovascular events, hypoglycemia events and fatal events, and decreased total costs compared with ACAR+MET. For an individual patient, the quality-adjusted life-years (QALYs) gained with SAXA+MET was 0.48 more than ACAR+MET at a cost saving of ¥18,736, which resulted in a cost saving of ¥38,640 per QALY gained for SAXA+MET versus ACAR+MET. Results were robust across various univariate and probabilistic sensitivity analyses.
  
  
  CONCLUSIONS
  SAXA+MET is a cost-effective treatment alternative compared with ACAR+MET for patients with T2DM in China, with a little QALYs gain and lower costs. SAXA is an effective, well-tolerated drug with a low incidence of adverse events and ease of administration; it is anticipated to be an effective second-line therapy for T2DM treatment.
authors.affiliation: Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China.
authors.forename: Shuyan
authors.initials: S
authors.lastname: Gu
authors.affiliation: Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China.
authors.forename: Yuhang
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.
authors.forename: Demin
authors.initials: D
authors.lastname: Yu
authors.affiliation: Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China.
authors.forename: Xiaoqian
authors.initials: X
authors.lastname: Hu
authors.affiliation: Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China.
authors.forename: Hengjin
authors.initials: H
authors.lastname: Dong
mesh_terms: D000218:Adamantane / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D044466:Asian People; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000191:economics / Q000401:mortality; D002681:China; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000191:economics* / Q000401:mortality; D004151:Dipeptides / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000191:economics / Q000401:mortality; D008297:Male; D008687:Metformin / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D018803:Models, Economic; D011788:Quality of Life
chemical_list: D004151:Dipeptides; D008687:Metformin; C502994:saxagliptin; D000218:Adamantane