title: Cost-effectiveness of vildagliptin for people with type 2 diabetes mellitus in Brazil; findings and implications.
abstract: Vildagliptin is an inhibitor of the enzyme dipeptidyl peptidase 4, indicated for the treatment of type 2 diabetes mellitus, combined or not with metformin. This study aims to evaluate the cost-effectiveness of vildagliptin in the Brazilian context. Areas covered: Using MEDLINE, Cochrane Library, Lilacs and CRD, six studies were selected for the economic models. This study utilised cost data in the Brazilian health system to provide the context. Expert commentary: Type 2 diabetes mellitus is an epidemic disease and represents a challenge for all health care systems. Although guidelines clearly define first-line treatment, there are several other promising treatments. Vildagliptin is one of them, resulting in a mean lifetime increase of 0.31 years compared to metformin alone and 1.19 more life years compared to other metformin combinations. Considering observational data, life years with dual vildagliptin-containing treatments were 0.37 more compared to other dual treatments. However, its high cost versus generic metformin and its unclear safety profile weakens its subsequent cost-effectiveness. Consequently, the incorporation of vildagliptin or its combination with metformin is currently not recommended for the Brazilian Health Care System. This may change as more data becomes available.
authors.affiliation: a Department of Social Pharmacy, School of Pharmacy , Federal University of Minas Gerais , Belo Horizonte , Brazil.|b Department of Management and Incorporation of Health Technology , Ministry of Health , Brasilia , Brazil.
authors.forename: Gustavo Laine Araujo
authors.initials: GL
authors.lastname: De Oliveira
authors.affiliation: a Department of Social Pharmacy, School of Pharmacy , Federal University of Minas Gerais , Belo Horizonte , Brazil.|c SUS Collaborating Centre - Technology Assessment & Excellence in Health, School of Pharmacy , Federal University of Minas Gerais , Minas Gerais , Brazil.
authors.forename: Augusto Afonso
authors.initials: AA
authors.lastname: Guerra Júnior
authors.affiliation: d Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , UK.|e Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet , Karolinska University Hospital Huddinge , Stockholm , Sweden.
authors.forename: Brian
authors.initials: B
authors.lastname: Godman
authors.affiliation: a Department of Social Pharmacy, School of Pharmacy , Federal University of Minas Gerais , Belo Horizonte , Brazil.|c SUS Collaborating Centre - Technology Assessment & Excellence in Health, School of Pharmacy , Federal University of Minas Gerais , Minas Gerais , Brazil.|f School of Medicine , Federal University of Minas Gerais , Belo Horizonte , Brazil.
authors.forename: Francisco de Assis
authors.initials: FA
authors.lastname: Acurcio
mesh_terms: D000218:Adamantane / Q000031:analogs & derivatives* / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D001938:Brazil; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D008687:Metformin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D018803:Models, Economic; D009570:Nitriles / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D011759:Pyrrolidines / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D000077597:Vildagliptin
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D009570:Nitriles; D011759:Pyrrolidines; D008687:Metformin; D000077597:Vildagliptin; D000218:Adamantane
keywords: Brazil; Vildagliptin; cost-effectiveness; metformin; type 2 diabetes