title: Evaluation of the long-term cost-effectiveness of IDegLira versus liraglutide added to basal insulin for patients with type 2 diabetes failing to achieve glycemic control on basal insulin in the USA.
abstract: OBJECTIVE
  IDegLira, a fixed ratio combination of insulin degludec and glucagon-like peptide-1 receptor agonist liraglutide, utilizes the complementary mechanisms of action of these two agents to improve glycemic control with low risk of hypoglycemia and avoidance of weight gain. The aim of the present analysis was to assess the long-term cost-effectiveness of IDegLira vs liraglutide added to basal insulin, for patients with type 2 diabetes not achieving glycemic control on basal insulin in the US setting.
  
  
  METHODS
  Projections of lifetime costs and clinical outcomes were made using the IMS CORE Diabetes Model. Treatment effect data for patients receiving IDegLira and liraglutide added to basal insulin were modeled based on the outcomes of a published indirect comparison, as no head-to-head clinical trial data is currently available. Costs were accounted in 2015 US dollars ($) from a healthcare payer perspective.
  
  
  RESULTS
  IDegLira was associated with small improvements in quality-adjusted life expectancy compared with liraglutide added to basal insulin (8.94 vs 8.91 discounted quality-adjusted life years [QALYs]). The key driver of improved clinical outcomes was the greater reduction in glycated hemoglobin associated with IDegLira. IDegLira was associated with mean costs savings of $17,687 over patient lifetimes vs liraglutide added to basal insulin, resulting from lower treatment costs and cost savings as a result of complications avoided.
  
  
  CONCLUSIONS
  The present long-term modeling analysis found that IDegLira was dominant vs liraglutide added to basal insulin for patients with type 2 diabetes failing to achieve glycemic control on basal insulin in the US, improving clinical outcomes and reducing direct costs.
authors.affiliation: a Ossian Health Economics and Communications , Basel , Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Hunt
authors.affiliation: b Novo Nordisk Inc. , Plainsboro , NJ , USA.
authors.forename: M
authors.initials: M
authors.lastname: Mocarski
authors.affiliation: a Ossian Health Economics and Communications , Basel , Switzerland.
authors.forename: W J
authors.initials: WJ
authors.lastname: Valentine
authors.affiliation: c Novo Nordisk A/S , Søborg , Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Langer
mesh_terms: D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure; D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D048909:Diabetes Complications / Q000191:economics / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004311:Double-Blind Method; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D007328:Insulin / Q000191:economics / Q000627:therapeutic use; D049528:Insulin, Long-Acting / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D000069450:Liraglutide / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D008390:Markov Chains; D018803:Models, Economic; D009010:Monte Carlo Method; D019057:Quality-Adjusted Life Years; D014481:United States; D015430:Weight Gain
chemical_list: D001786:Blood Glucose; D004338:Drug Combinations; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D008055:Lipids; D000069450:Liraglutide; C000613158:IDegLira; C571886:insulin degludec
keywords: Cost; IDegLira; USA; cost-effectiveness; liraglutide; type 2 diabetes mellitus