Jakob Langer

Improved real‐world glycaemic outcomes with liraglutide versus other incretin‐based therapies in type 2 diabetes

Liraglutide (LIRA) once‐daily has provided greater A1C reductions than either exenatide (EXEN) twice‐daily or sitagliptin (SITA) once‐daily in head‐to‐head trials. The objective of this analysis is to compare the real‐world clinical effectiveness of these agents in the USA.

Long-term clinical and economic outcomes associated with liraglutide versus sitagliptin therapy when added to metformin in the treatment of type 2 diabetes: a CORE Diabetes Model analysis

Abstract Background: A recent open-label, parallel group trial showed that liraglutide is superior to sitagliptin for reduction of HbA1c, and is well tolerated with minimum risk of hypoglycemia. Although these findings support the use of liraglutide as an effective GLP-1 agent to add to metformin, the value of liraglutide needs to be quantified in the framework of a cost-effectiveness (CE) analysis in a US setting. Objective: This current study sets out to assess the long-term cost-effectiveness outcomes of liraglutide vs sitagliptin based on treatment effects data from the 1860-LIRA-DPP-4 52-week trial. Methods: The IMS CORE Diabetes Model (CDM), a non-product-specific, validated computer simulation model that projects the long-term outcomes related to interventions for type 2 diabetes, is used for simulation of these interventions. In the model, patients were treated initially on one of the three treatment options: liraglutide 1.2 mg daily, 1.8 mg daily, or sitagliptin 100 mg daily, each used as add-on therapy to metformin for 5 years. After 5 years all patients switched to basal insulin treatment for the remainder of the simulation (35-year time horizon overall). Incremental cost-effectiveness ratios (ICERs) were generated for liraglutide 1.2 mg compared with sitagliptin and liraglutide 1.8 mg compared with sitagliptin. Transition probabilities, health state utility values, and complication costs were obtained from published sources. All outcomes were discounted at 3% per annum, and the analysis was conducted from the perspective of a third-party payer in the US. Sensitivity analyses were performed to test robustness of the base case scenario. Results: For liraglutide 1.8 mg vs sitagliptin, the ICER was

Evaluation of the long-term cost-effectiveness of IDegLira versus liraglutide added to basal insulin for patients with type 2 diabetes failing to achieve glycemic control on basal insulin in the USA

37,234 per QALY gained, while for liraglutide 1.2 mg vs sitagliptin, the ICER was

Evaluation of the Short-Term Cost-Effectiveness of IDegLira Versus Continued Up-Titration of Insulin Glargine U100 in Patients with Type 2 Diabetes in the USA

25,742 per QALY gained. In all sensitivity analyses, including setting the change in HbA1c to the lower limits of the 95% confidence intervals, the ICERs remained below US

IDegLira Versus Insulin Glargine U100: A Long-term Cost-effectiveness Analysis in the US Setting

50,000/QALY, a commonly accepted threshold in the US, except for the shortest time horizon of 10 years. Conclusions: The availability of liraglutide 1.2 mg and 1.8 mg with improved efficacy profiles over sitagliptin could improve patient care, with the incremental cost effectiveness ratio below

Predictors of glycemic control and diabetes-related costs among type 2 diabetes patients initiating therapy with liraglutide in the United States.

50,000 per QALY gained as add-on to metformin.

Real-World Clinical Effectiveness of Liraglutide in Individuals 65 Years and Older with Type 2 Diabetes in the United States

Abstract Background and aims: IDegLira, a fixed ratio combination of insulin degludec and glucagon-like peptide-1 receptor agonist liraglutide, utilizes the complementary mechanisms of action of these two agents to improve glycemic control with low risk of hypoglycemia and avoidance of weight gain. The aim of the present analysis was to assess the long-term cost-effectiveness of IDegLira vs liraglutide added to basal insulin, for patients with type 2 diabetes not achieving glycemic control on basal insulin in the US setting. Methods: Projections of lifetime costs and clinical outcomes were made using the IMS CORE Diabetes Model. Treatment effect data for patients receiving IDegLira and liraglutide added to basal insulin were modeled based on the outcomes of a published indirect comparison, as no head-to-head clinical trial data is currently available. Costs were accounted in 2015 US dollars (

Comparative Real World Effectiveness of Liraglutide versus Sitagliptin in Patients with Type 2 Diabetes as an Add-On to Metformin Monotherapy in the United States

) from a healthcare payer perspective. Results: IDegLira was associated with small improvements in quality-adjusted life expectancy compared with liraglutide added to basal insulin (8.94 vs 8.91 discounted quality-adjusted life years [QALYs]). The key driver of improved clinical outcomes was the greater reduction in glycated hemoglobin associated with IDegLira. IDegLira was associated with mean costs savings of

Long-term cost-effectiveness analysis shows that IDegLira is associated with improved outcomes and lower costs compared with insulin glargine U100 plus insulin aspart in the US

17,687 over patient lifetimes vs liraglutide added to basal insulin, resulting from lower treatment costs and cost savings as a result of complications avoided. Conclusions: The present long-term modeling analysis found that IDegLira was dominant vs liraglutide added to basal insulin for patients with type 2 diabetes failing to achieve glycemic control on basal insulin in the US, improving clinical outcomes and reducing direct costs.

Slow Titration and Delayed Intensification of Basal Insulin Among Patients with Type 2 Diabetes

IntroductionEffective glycemic control can reduce the risk of complications and their related costs in type 2 diabetes mellitus (T2DM). However, many patients fail to reach glycemic targets, often because of adverse effects of treatment (including hypoglycemia or weight gain). The present analysis evaluated the short-term cost-effectiveness of IDegLira versus continued up-titration of insulin glargine U100 in patients with T2DM failing to achieve glycemic control on basal insulin in the US setting.MethodsThe cost per patient achieving treatment target (cost of control) was assessed for various single and composite endpoints for the entire trial population and in patients with baseline glycated hemoglobin (HbA1c) >8.0% and HbA1c >9.0%. The proportions of patients achieving treatment targets were analyzed using data obtained in the DUAL V study. Costs were accounted based on published wholesale acquisition costs.ResultsWhen assessing the full trial population, IDegLira was associated with lower annual cost of control than continued up-titration of insulin glargine U100 for patients achieving HbA1c ≤6.5% without confirmed hypoglycemia (by