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首页> 美国卫生研究院文献>MDM Policy Practice >Cost-Effectiveness of Saxagliptin Compared With Glibenclamide as a Second-Line Therapy Added to Metformin for Type 2 Diabetes Mellitus in Ethiopia
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Cost-Effectiveness of Saxagliptin Compared With Glibenclamide as a Second-Line Therapy Added to Metformin for Type 2 Diabetes Mellitus in Ethiopia

机译：与Glibenclamide相比Saxagliptin的成本效益与Glibenclamide作为埃塞俄比亚2型糖尿病的二甲双胍添加到二甲双胍中

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Background. Metformin is a widely accepted first-line pharmacotherapy for patients with type 2 diabetes mellitus (T2DM). Treatment of T2DM with glibenclamide, saxagliptin, or one of the other second-line treatment agents is recommended when the first-line treatment (metformin) cannot control the disease. However, there is little evidence on the additional cost and cost-effectiveness of adding second-line drugs. Therefore, this study aimed to estimate the cost-effectiveness of saxagliptin and glibenclamide as second-line therapies added to metformin compared with metformin only in T2DM in Ethiopia. Methods. This cost-effectiveness study was conducted in Ethiopia using a mix of primary data on cost and best available data from the literature on the effectiveness. We measured the interventions’ cost from the providers’ perspective in 2019 US dollars. We developed a Markov model for T2DM disease progression with five health states using TreeAge Pro 2020 software. Disability-adjusted life year (DALY) was the health outcome used in this study, and we calculated the incremental cost-effectiveness ratio (ICER) per DALY averted. Furthermore, one-way and probabilistic sensitivity analysis were performed. Results. The annual unit cost per patient was US$70 for metformin, US$75 for metformin + glibenclamide, and US$309 for metformin + saxagliptin. The ICER for saxagliptin + metformin was US$2259 per DALY averted. The ICER results were sensitive to various changes in cost, effectiveness, and transition probabilities. The ICER was driven primarily by the higher cost of saxagliptin relative to glibenclamide. Conclusion. Our study revealed that saxagliptin is not a cost-effective second-line therapy in patients with T2DM inadequately controlled by metformin monotherapy based on a gross domestic product per capita per DALY averted willingness-to-pay threshold in Ethiopia (US$953).
机译：背景。二甲双胍是患有2型糖尿病（T2DM）的患者的广泛接受的一线药物疗法。当第一线处理（二甲双胍）无法控制疾病时，建议使用Glibenclamide，Saxagliptin或其他第二线处理剂中的一种处理T2DM。但是，还有一些关于加入二线药物的额外成本和成本效益的证据。因此，本研究旨在估算Saxagliptin和Glibenclamide的成本效益，因为在埃塞俄比亚的T2DM中仅添加到二甲双胍中加入二甲双胍的二线疗法。方法。这种成本效益研究在埃塞俄比亚进行了一系列关于成本和来自文献的最佳数据的初级数据对效果。我们从2019年的供应商的角度衡量了从供应商的角度来看的干预措施。我们开发了一种Markov模型，用于使用Treeage Pro 2020软件与五个健康状态的T2DM疾病进展。残疾人寿命年度（DALY）是本研究中使用的健康结果，我们计算了每DALY避免的增量成本效益率（ICER）。此外，进行单向和概率敏感性分析。结果。 Metombin + Metformin + Glibenclamide的年度单位成本为Metformin，75美元，以及Metformin + Saxagliptin的309美元。 Saxagliptin + Metformin的ICER为每DALY避免2259美元。转换结果对成本，有效性和过渡概率的各种变化敏感。该转换器主要通过相对于Glibenclamide的Saxagliptin的更高成本驱动。结论。我们的研究表明，Saxagliptin不是在埃塞俄比亚人均国内生产总产值的毛蛋白单疗法的T2DM患者患者的经济高效的二线治疗患者，该患者每位达利均可避免埃塞俄比亚的愿意支付门槛（953美元）。

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