CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

Cost-effectiveness of two diabetes drugs for Canadian patients with high heart disease risk and type 2 diabetes

Updated

Abstract

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) produced 0.24 more quality-adjusted life-years (QALYs) compared to baseline treatment.

  • SGLT2i and glucagon-like peptide-1 receptor agonists (GLP-1 RA) reduced lifetime rates of cardiovascular and renal events compared to baseline treatment.
  • SGLT2i were associated with a net present cost increase of +$5000, while GLP-1 RA increased costs by +$27,000.
  • SGLT2i had a cost-effectiveness ratio of $21,400 per QALY gained and were consistently cost-effective in sensitivity analyses.
  • In 62% of probabilistic sensitivity analysis iterations, GLP-1 RA produced fewer QALYs at a higher cost than SGLT2i.

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Funding

Competing interests

Competing interests:: Pedro Marques reports receiving honoraria from Novartis, Bial, Recordati, and Daiichi-Sankyo, and support for attending meetings from Bial, Daiichi-Sankyo, and Servier. Ankur Pandya reports serving as President-Elect, Society for Medical Decision-Making (unpaid). Abhinav Sharma reports receiving support for the present manuscript from Mitacs and the McGill University Health Centre Foundation. Outside the submitted work, Dr. Sharma reports receiving grants from Astra-Zeneca, Boehringer-Ingelheim, Medtronic, Merck, Novartis, Novo Nordisk, Takeda Development Center Americas, Roche Diagnostics, Janssen, and Eli-Lilly; consulting fees from AstraZeneca, Boehringer-Ingelheim, Eli Lilly, Servier, Novo Nordisk, Novartis, Viatris, Vifor Pharma, and Bayer Inc.; and honoraria from AstraZeneca, Boehringer-Ingelheim, Novo Nordisk, and Novartis. Dr. Sharma reports holding patents in AeroCardia, Perc-Assist, and AREA19; stock in AREA19; and equity in AREA19, AeroCardia, and Perc-Assist. Michael Tsoukas reports receiving speaker honoraria from Novo Nordisk, Eli Lilly, Boehringer-Ingelheim, Janssen, Sanofi, and Abbott. Thomas Mavrakanas reports receiving salary support from a clinician research scholar J2 award from the Fonds de Recherche de Santé—Québec (in support of the current manuscript), and has received research grants from AstraZeneca, the Canadian Institute of Health Research, and the Heart & Stroke Foundation of Canada, as well as fellowship grants from Pfizer, Janssen, and Bayer (outside the submitted work, payment to institution). Dr. Mavrakanas has also received speaker honoraria from Bayer, Janssen, AstraZeneca, Novo Nordisk, and Boehringer-Ingelheim, and has served on advisory boards for Boehringer-Ingelheim, Servier, GSK, Novo Nordisk, and Bayer. No other competing interests were declared.
PubMed

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