The diminishing cost-effectiveness of the newer glucose-lowering drug classes in the United States: 2010–2018
| Autor: | Lizheng Shi, Jingchuan Guo, Hui Shao, Scott Martin Vouri, Vivian Fonseca, Piaopiao Li, Rahul K. Patel |
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| Rok vydání: | 2021 |
| Předmět: |
Drug
Glucose lowering Dipeptidyl-Peptidase IV Inhibitors medicine.medical_specialty Cost estimate Cost effectiveness business.industry Cost-Benefit Analysis media_common.quotation_subject General Medicine Glucagon-Like Peptide-1 Receptor United States Glucose Diabetes Mellitus Type 2 Willingness to pay Time windows medicine Humans Hypoglycemic Agents Insulin Claims database Intensive care medicine business health care economics and organizations media_common |
| Zdroj: | Current Medical Research and Opinion. 37:1875-1880 |
| ISSN: | 1473-4877 0300-7995 |
| DOI: | 10.1080/03007995.2021.1971181 |
| Popis: | Background The difference between the costs of the newer and older glucose-lowering drugs (GLMs) has been steadily increasing since 2010. In 2018, newer drugs cost 8-12 times more than older drugs (except for insulin). This study aimed to understand how the cost change influenced the cost-effectiveness of the newer GLMs. Methods Based on our previous literature review on US-based cost-effectiveness studies comparing newer (i.e., dipeptidyl peptidase-4 inhibitors (DPP4), glucagon-like peptide 1 receptor agonists (GLP1-RA), and sodium-glucose transport protein 2 inhibitors) with older GLMs, we identified 12 studies that reported the cost-effectiveness of newer drugs based on drug costs estimated before 2010. We updated the corresponding cost-effectiveness of each study by replacing the old cost estimates with 2018 estimates from the 2018 IBM® MarketScan® Commercial Claims Databases. The time window and willingness to pay threshold were consistent with the original studies. Results Only 8% of the original studies suggested that the older drugs were cost-effective. However, 58% of studies were in favor of the older drugs after the cost update. Among the four studies comparing newer drugs with thiazolidinediones, all the original results favored newer drugs. However, all studies suggested thiazolidinedione to be cost-effective in the updated analysis. For the four studies comparing newer drugs with sulfonylureas, two studies suggested the sulfonylureas to be cost-effective after the cost update. All four studies suggested newer drugs to be cost-effective when compared with insulin in the original study. Only 1 flipped its conclusion when 2018 costs were used. Our sensitivity analysis shows that our results are robust under a 30% rebate. Conclusion Significant changes in the cost of GLMs have impacted the economic value of different GLM classes substantially. More cost-effectiveness analyses are warranted to support the drug choice in T2DM management. |
| Databáze: | OpenAIRE |
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