Cost-effectiveness of Empagliflozin, in Addition to Metformin, in Patients with Type 2 Diabetes in Italy
BACKGROUND: Cardiovascular diseases represent the main cause of mortality and morbidity in type 2 diabetes mellitus (T2DM) patients. Empagliflozin is used as a treatment for T2DM because of its association with reduced risk of hospitalization for heart failure (hHF). Recently oral semaglutide, in as...
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| Format: | Article |
| Language: | English |
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SEEd Medical Publishers
2022-12-01
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| Series: | Farmeconomia: Health Economics and Therapeutic Pathways |
| Subjects: | |
| Online Access: | http://journals.seedmedicalpublishers.com/index.php/FE/article/view/1539 |
| _version_ | 1797860898910502912 |
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| author | Edoardo Mannucci Gianni Ghetti |
| author_facet | Edoardo Mannucci Gianni Ghetti |
| author_sort | Edoardo Mannucci |
| collection | DOAJ |
| description | BACKGROUND: Cardiovascular diseases represent the main cause of mortality and morbidity in type 2 diabetes mellitus (T2DM) patients. Empagliflozin is used as a treatment for T2DM because of its association with reduced risk of hospitalization for heart failure (hHF). Recently oral semaglutide, in association with metformin, has shown better results. This study analyzes the cost-effectiveness of empagliflozin versus oral semaglutide, in addition to metformin, in patients with T2DM who are inadequately controlled on metformin alone in Italy.
METHODS: This analysis was conducted from the Italian National Health Service (SSN) perspective using the IQVIA Core Diabetes Model. For the base case analysis, a 50-year time horizon was chosen to capture the complications, their associated costs, and the final impact on life-years (LYs) and quality-adjusted life-years (QALYs) gained. Cohort baseline characteristics and efficacy data, were mainly sourced from the PIONEER 2 study. Health-state utilities and event disutilities were based on published sources. Drug acquisition and administration costs and patient management inputs were sourced from Italian-specific data. A sensitivity analysis and a range of scenario analyses were carried out.
RESULTS: In the base case analysis treatment cost of empagliflozin plus metformin were significantly lower compared to oral semaglutide plus metformin both including and excluding the effect of empagliflozin on hHF (€-13.371/€-13.580; LYs -0.004/0.109 and QALYs -0.037/0.038). The sensitivity analysis confirmed the robustness of the model with empagliflozin plus metformin that was dominant in 63% and in 42% of simulations considering and non-considering the treatment effect on hHF, respectively.
CONCLUSIONS: Empagliflozin 25 mg plus metformin is a cost-effective option versus oral semaglutide 14 mg plus metformin for patients with T2DM uncontrolled on metformin alone in Italy |
| first_indexed | 2024-04-09T21:53:23Z |
| format | Article |
| id | doaj.art-a87b113c3c5a4b53841b28ca3af2fbfe |
| institution | Directory Open Access Journal |
| issn | 2240-256X |
| language | English |
| last_indexed | 2024-04-09T21:53:23Z |
| publishDate | 2022-12-01 |
| publisher | SEEd Medical Publishers |
| record_format | Article |
| series | Farmeconomia: Health Economics and Therapeutic Pathways |
| spelling | doaj.art-a87b113c3c5a4b53841b28ca3af2fbfe2023-03-24T11:03:15ZengSEEd Medical PublishersFarmeconomia: Health Economics and Therapeutic Pathways2240-256X2022-12-0123110.7175/fe.v23i1.15391353Cost-effectiveness of Empagliflozin, in Addition to Metformin, in Patients with Type 2 Diabetes in ItalyEdoardo Mannucci0Gianni Ghetti1Diabetology, Careggi Hospital and University of Florence, Florence, ItalyAdRes HE&OR, Turin, ItalyBACKGROUND: Cardiovascular diseases represent the main cause of mortality and morbidity in type 2 diabetes mellitus (T2DM) patients. Empagliflozin is used as a treatment for T2DM because of its association with reduced risk of hospitalization for heart failure (hHF). Recently oral semaglutide, in association with metformin, has shown better results. This study analyzes the cost-effectiveness of empagliflozin versus oral semaglutide, in addition to metformin, in patients with T2DM who are inadequately controlled on metformin alone in Italy. METHODS: This analysis was conducted from the Italian National Health Service (SSN) perspective using the IQVIA Core Diabetes Model. For the base case analysis, a 50-year time horizon was chosen to capture the complications, their associated costs, and the final impact on life-years (LYs) and quality-adjusted life-years (QALYs) gained. Cohort baseline characteristics and efficacy data, were mainly sourced from the PIONEER 2 study. Health-state utilities and event disutilities were based on published sources. Drug acquisition and administration costs and patient management inputs were sourced from Italian-specific data. A sensitivity analysis and a range of scenario analyses were carried out. RESULTS: In the base case analysis treatment cost of empagliflozin plus metformin were significantly lower compared to oral semaglutide plus metformin both including and excluding the effect of empagliflozin on hHF (€-13.371/€-13.580; LYs -0.004/0.109 and QALYs -0.037/0.038). The sensitivity analysis confirmed the robustness of the model with empagliflozin plus metformin that was dominant in 63% and in 42% of simulations considering and non-considering the treatment effect on hHF, respectively. CONCLUSIONS: Empagliflozin 25 mg plus metformin is a cost-effective option versus oral semaglutide 14 mg plus metformin for patients with T2DM uncontrolled on metformin alone in Italyhttp://journals.seedmedicalpublishers.com/index.php/FE/article/view/1539empagliflozintype 2 diabetes mellituscost-effectivenessitaly |
| spellingShingle | Edoardo Mannucci Gianni Ghetti Cost-effectiveness of Empagliflozin, in Addition to Metformin, in Patients with Type 2 Diabetes in Italy Farmeconomia: Health Economics and Therapeutic Pathways empagliflozin type 2 diabetes mellitus cost-effectiveness italy |
| title | Cost-effectiveness of Empagliflozin, in Addition to Metformin, in Patients with Type 2 Diabetes in Italy |
| title_full | Cost-effectiveness of Empagliflozin, in Addition to Metformin, in Patients with Type 2 Diabetes in Italy |
| title_fullStr | Cost-effectiveness of Empagliflozin, in Addition to Metformin, in Patients with Type 2 Diabetes in Italy |
| title_full_unstemmed | Cost-effectiveness of Empagliflozin, in Addition to Metformin, in Patients with Type 2 Diabetes in Italy |
| title_short | Cost-effectiveness of Empagliflozin, in Addition to Metformin, in Patients with Type 2 Diabetes in Italy |
| title_sort | cost effectiveness of empagliflozin in addition to metformin in patients with type 2 diabetes in italy |
| topic | empagliflozin type 2 diabetes mellitus cost-effectiveness italy |
| url | http://journals.seedmedicalpublishers.com/index.php/FE/article/view/1539 |
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