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Health Technology Assessment (HTA) of GLP-1 receptor agonists and SGLT-2 inhibitors in combination with metformin as first-line treatment in patient with type 2 diabetes mellitus (T2DM) and established cardiovascular or chronic kidney disease

Author

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  • Aas, Eline

    (Division of Health Services, Norwegian Institute of Public Health,)

  • Gomez, Monica

    (Department of Health Management and Health Economics)

  • Tariq, Fawaz

    (Department of Health Management and Health Economics)

Abstract

Type 2 diabetes mellitus (T2DM) is one of the most prevalent lifestyle-related diseases, causing increased mortality, morbidity and reduction in health-related quality of life (HRQoL), as well as costs to society related to treatment, follow-up and production losses.In the current guidelines, SGLT-2 inhibitors and GLP-1 analogs are recommended as second-line treatment for T2DM. Based on results from recent studies, we have in this report analyzed whether these drugs can be considered cost-effective as first-line treatment (in combination with metformin) for patients with T2DM with either established cardiovascular disease or chronic renal failure (only SGLT-2 inhibitors considered). Based on two decision analytic models we estimated the incremental cost per QALYs gained. For the patients with T2DM and established CVD, SGLT-2 i is the preferred alternative (ICER NOK 59,811 per LY gained and NOK 89,517 per QALY gained) and is superior to GLP-1 RA, as SGLT-2 I resulted in higher health outcomes than GLP-1 RA. For patients with T2DM and established renal failure when comparing SGLT-2 i to metformin results in an ICER of NOK 168,872 per LY gained and NOK 193,656 per QALY gained. Both ICERs fall below the the threshold for these two patient groups are NOK 475,000

Suggested Citation

  • Aas, Eline & Gomez, Monica & Tariq, Fawaz, 2022. "Health Technology Assessment (HTA) of GLP-1 receptor agonists and SGLT-2 inhibitors in combination with metformin as first-line treatment in patient with type 2 diabetes mellitus (T2DM) and establishe," HERO Online Working Paper Series 2022:3, University of Oslo, Health Economics Research Programme.
    • Handle: RePEc:hhs:oslohe:2022_003
    DOI: https://www.med.uio.no/helsam/forskning/nettverk/hero/publikasjoner/skriftserie/2022/3.html
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884, Decembrie.
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    More about this item

    Keywords

    Type 2 diabetes; retningslinjer; kostnadseffektivitetsanalyse; SGLT-2 I; GLP1-RA;
    All these keywords.

    JEL classification:

    • C52 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Evaluation, Validation, and Selection
    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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