Evaluating the costs of glycemic response with canagliflozin versus dapagliflozin and empagliflozin as add-on to metformin in patients with type 2 diabetes mellitus in the United Arab Emirates.
This study evaluates the cost of achieving glycemic control with three sodium glucose co-transporter 2 (SGLT2) inhibitors, canagliflozin, dapagliflozin, and empagliflozin, in patients with type 2 diabetes mellitus (T2DM) from the payer perspective in the United Arab Emirates (UAE).



A systematic literature review identified randomized controlled trials of antihyperglycemic agents as add-on to metformin in patients with T2DM of 26 ± 4 weeks in duration, published by 10 September 2014. A Bayesian network-meta analysis (NMA) compared HbA1c changes with canagliflozin 100 and 300 mg versus dapagliflozin 10 mg and empagliflozin 10 and 25 mg. The cost associated with a 1% placebo-adjusted HbA1c reduction with each SGLT2 inhibitor as add-on to metformin was calculated based on NMA results and UAE drug costs.



In the NMA, canagliflozin 100 and 300 mg were associated with HbA1c reductions (-0.67% and -0.79%) compared with dapagliflozin 10 mg (-0.41%) and empagliflozin 10 and 25 mg (-0.57% and -0.64%). Probabilities of canagliflozin 100 mg performing better were 79%, 60%, and 53% versus dapagliflozin 10 mg and empagliflozin 10 and 25 mg, respectively; probabilities for canagliflozin 300 mg performing better were 88%, 72%, and 65%, respectively. The cost per 1%-point reduction in HbA1c was projected to be lower with canagliflozin 100 and 300 mg ($448 and $422) compared with dapagliflozin 10 mg ($785) and empagliflozin 10 and 25 mg ($527 and $563).



Canagliflozin may provide a greater glycemic response at a lower effective cost than dapagliflozin or empagliflozin for patients with T2DM inadequately controlled with metformin from the payer perspective in the UAE.
a Janssen-Cilag Poland , Warsaw , Poland.
Agata
A
Schubert
b Janssen-Cilag A/S , Birkerød , Denmark.
Anders T
AT
Buchholt
c Janssen-Cilag , Dubai , UAE.
Antoine C
AC
El Khoury
c Janssen-Cilag , Dubai , UAE.
Ahmed
A
Kamal
d Amaris , London , UK.
Vanessa
V
Taieb
D006801:Humans; D001499:Bayes Theorem; D001559:Benzhydryl Compounds / Q000191:economics / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects; D000068896:Canagliflozin / Q000191:economics / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000191:economics; D005960:Glucosides / Q000191:economics / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use; D008687:Metformin / Q000191:economics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D014479:United Arab Emirates
D001559:Benzhydryl Compounds; D001786:Blood Glucose; D000068896:Canagliflozin; C529054:dapagliflozin; C570240:empagliflozin; D005960:Glucosides; D007004:Hypoglycemic Agents; D008687:Metformin; D000077203:Sodium-Glucose Transporter 2 Inhibitors
Canagliflozin; Comparative effectiveness; Network meta-analysis; Sodium glucose co-transporter 2 (SGLT2) inhibitors; Type 2 diabetes mellitus; United Arab Emirates