دورية أكاديمية
أعرض في EDS

Cost-effectiveness of empagliflozin versus canagliflozin, dapagliflozin, or standard of care in patients with type 2 diabetes and established cardiovascular disease.

التفاصيل البيبلوغرافية
العنوان: Cost-effectiveness of empagliflozin versus canagliflozin, dapagliflozin, or standard of care in patients with type 2 diabetes and established cardiovascular disease.
المؤلفون: Reifsnider OS; Evidera Inc, Bethesda, Maryland, USA odette.reifsnider@evidera.com., Kansal AR; Evidera Inc, Bethesda, Maryland, USA., Gandhi PK; Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, USA., Cragin L; Evidera Inc, Bethesda, Maryland, USA., Brand SB; Evidera Inc, Bethesda, Maryland, USA., Pfarr E; Boehringer Ingelheim Pharma GmbH and Co KG, Ingelheim, Rheinland-Pfalz, Germany., Fahrbach K; Evidera Waltham, Waltham, Massachusetts, USA., Ustyugova A; Boehringer Ingelheim Pharma GmbH and Co KG, Ingelheim, Rheinland-Pfalz, Germany.
المصدر: BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2021 May; Vol. 9 (1).
نوع المنشور: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Published by BMJ in partnership with the American Diabetes Association Country of Publication: England NLM ID: 101641391 Publication Model: Print Cited Medium: Internet ISSN: 2052-4897 (Electronic) Linking ISSN: 20524897 NLM ISO Abbreviation: BMJ Open Diabetes Res Care Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : Published by BMJ in partnership with the American Diabetes Association
مواضيع طبية MeSH: Cardiovascular Diseases*/epidemiology , Cardiovascular Diseases*/prevention & control , Diabetes Mellitus, Type 2*/drug therapy , Diabetes Mellitus, Type 2*/epidemiology, Adult ; Benzhydryl Compounds ; Canagliflozin/therapeutic use ; Cost-Benefit Analysis ; Glucosides ; Humans ; Hypoglycemic Agents/therapeutic use ; Standard of Care
مستخلص: Introduction: Empagliflozin, a sodium-glucose co-transporter-2 (SGLT-2) inhibitor, is approved in the USA to reduce risk of cardiovascular (CV) death in adults with type 2 diabetes mellitus (T2DM) and established CV disease, based on EMPA-REG OUTCOME (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) trial results. Empagliflozin reduced major adverse CV event (MACE) by 14%, CV death by 38%, and hospitalization for heart failure (HHF) by 35% vs placebo, each on top of standard of care (SoC). SGLT-2 inhibitors canagliflozin and dapagliflozin have also been compared with placebo, all on top of SoC, in CV outcome trials. In the CANVAS (Canagliflozin Cardiovascular Assessment Study) Program, canagliflozin reduced MACE by 14% and HHF by 33%. Dapagliflozin reduced HHF by 27% in the DECLARE-TIMI 58 trial (Multicenter Trial to Evaluate the Effect of Dapagliflozin on the Incidence of Cardiovascular Events). This analysis estimated the cost-effectiveness of empagliflozin versus canagliflozin, dapagliflozin, or SoC, in US adults with T2DM and established CV disease.
Research Design and Methods: Individual patient-level discrete-event simulation was conducted to predict time-to-event for CV and renal outcomes, and specific adverse events over patients' lifetimes. Occurrence of events in EMPA-REG OUTCOME was estimated based on event-free survival curves with time-dependent covariates. An HR for canagliflozin or dapagliflozin versus empagliflozin on each clinical event was estimated from published CANVAS, DECLARE-TIMI 58, and EMPA-REG OUTCOME data using indirect treatment comparison. Public sources provided US costs and utilities.
Results: The model predicted longer survival for empagliflozin versus canagliflozin, dapagliflozin, and SoC mainly due to direct reduction in CV death. Empagliflozin dominated canagliflozin, yielding more quality-adjusted life years (QALYs; 0.38) at a lower cost (-US$306). Compared with dapagliflozin and SoC, empagliflozin yielded 0.50 and 0.84 incremental QALYs at US$1517 and US$27 539 incremental costs, yielding incremental cost-effectiveness ratios of US$3054/QALY and US$32 848/QALY, respectively.
Conclusions: Empagliflozin was projected to dominate canagliflozin and be highly cost-effective compared with dapagliflozin and SoC using US healthcare costs.
Competing Interests: Competing interests: OSR, SBB, and KF are employees of Evidera, which provides consulting and other research services to the biopharmaceutical industry. ARK and LC were employees of Evidera during the conduct of this study and development of this article, but are now employed elsewhere. In their salaried positions, Evidera employees work with a variety of companies and organizations, and are precluded from receiving any payment or honoraria directly from these organisations for services rendered. Evidera received funding from Boehringer Ingelheim Pharma GmbH & Co KG. EP and AU are current employees of Boehringer Ingelheim Pharma GmbH & Co. KG of Ingelheim am Rhein, Germany. PKG was an employee of Boehringer Ingelheim Pharmaceuticals, Inc. in Ridgefield, Connecticut, USA during the conduct of this study and development of this article, but he is now employed elsewhere.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
References: Value Health. 2012 Sep-Oct;15(6):835-42. (PMID: 22999133)
Lancet Diabetes Endocrinol. 2017 Nov;5(11):877-886. (PMID: 28917545)
N Engl J Med. 2016 Nov 10;375(19):1834-1844. (PMID: 27633186)
J Clin Epidemiol. 1997 Jun;50(6):683-91. (PMID: 9250266)
Lancet. 2014 Mar 15;383(9921):999-1008. (PMID: 24084292)
JAMA. 2019 Jan 1;321(1):69-79. (PMID: 30418475)
Clin Ther. 2019 Oct;41(10):2021-2040.e11. (PMID: 31561882)
N Engl J Med. 2016 Jul 28;375(4):311-22. (PMID: 27295427)
Circulation. 2018 Jan 23;137(4):323-334. (PMID: 29133604)
Diabetes Care. 2018 May;41(5):917-928. (PMID: 29567642)
J Med Econ. 2019 Mar;22(3):280-287. (PMID: 30575426)
N Engl J Med. 2013 Oct 3;369(14):1327-35. (PMID: 23992602)
J Med Econ. 2013 Nov;16(11):1327-43. (PMID: 24032651)
Am J Prev Med. 2013 Sep;45(3):253-61. (PMID: 23953350)
Clin Drug Investig. 2018 May;38(5):417-426. (PMID: 29349708)
N Engl J Med. 2019 Jan 24;380(4):347-357. (PMID: 30415602)
N Engl J Med. 2017 Aug 17;377(7):644-657. (PMID: 28605608)
N Engl J Med. 2013 Oct 3;369(14):1317-26. (PMID: 23992601)
J Am Coll Cardiol. 2008 Dec 16;52(25):2119-26. (PMID: 19095128)
N Engl J Med. 2019 Jun 13;380(24):2295-2306. (PMID: 30990260)
N Engl J Med. 2015 Nov 26;373(22):2117-28. (PMID: 26378978)
Diabetes Care. 2018 Jan;41(1):14-31. (PMID: 29263194)
Health Qual Life Outcomes. 2012 Aug 21;10:99. (PMID: 22917219)
Diabet Med. 2019 Nov;36(11):1494-1502. (PMID: 31295358)
Value Health. 2016 Dec;19(8):1002-1008. (PMID: 27987626)
BMJ. 2006 Sep 2;333(7566):475-80. (PMID: 16946335)
J Diabetes Complications. 2018 Feb;32(2):210-215. (PMID: 29157870)
Eur Heart J. 2007 Jun;28(12):1448-53. (PMID: 17371782)
N Engl J Med. 2017 Aug 24;377(8):723-732. (PMID: 28605603)
N Engl J Med. 2015 Jul 16;373(3):232-42. (PMID: 26052984)
فهرسة مساهمة: Keywords: cardiovascular system; cost effectiveness; sodium glucose cotransporter; type 2 diabetes
المشرفين على المادة: 0 (Benzhydryl Compounds)
0 (Glucosides)
0 (Hypoglycemic Agents)
0SAC974Z85 (Canagliflozin)
1ULL0QJ8UC (dapagliflozin)
HDC1R2M35U (empagliflozin)
تواريخ الأحداث: Date Created: 20210504 Date Completed: 20210621 Latest Revision: 20210621
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8098979
DOI: 10.1136/bmjdrc-2020-001313
PMID: 33941549
قاعدة البيانات: MEDLINE
الوصف
تدمد:2052-4897
DOI:10.1136/bmjdrc-2020-001313