The pharmacoeconomic comparison of the fixed insulin glargine and lixisenatide combination with insulin degludec family in type 2 diabetes mellitus

Abstract

Insulin glargine 100 U/ml (iGla) is gradually giving way to a fixed combination of insulin glargine 100 U/ml+ lixisenatide (iGlaLixi) — an effective and safe drug for Diabetes Mellitus Type 2 (DM2T) control. It has demonstrated the economic benefits in naïve patients as well as for treatment intensification aft er failure of insulins. Economic aspects of iGlaLixi in DM2T in comparison with another effective drugs — insulin degludec (iDeg) and insulin degludec + insulin aspart (iDegAsp) were not evaluated before.Materials and methods. Indirect treatment comparison (ITC) for iGlaLixi with others EDL drugs — iDeg and iDegAsp — has been performed through common comparator — iGla based on published results of efficacy in naïve and insulinized DM2T patients separately. Patients reached target HbA1c level (%) were chosen as a criterion of drugs efficacy. Odds ratio (OR) of efficacy has been calculated, modelling has been performed for direct and indirect costs. Sensitivity analysis was done for validation of results.Results. Efficacy of iGlaLixi were higher as well in naïve as in insulinized patients in comparison with iDeg family: with iDeg comparison OR 2.23 (95 % CI 1.40; 3.53); 3.34 (2.06; 5.40), with iDegAsp OR 1.90 (1.23; 2.95) и 2.49 (1.54; 4.04) accordingly. Direct costs in sum for iGlaLixi were less for iDeg on 22.1, and on 18.3 % for iDegAsp in naïve patient group, and on 35.9 % and 7.0 % for insulinized patients respectively. In total expenditures (direct and indirect costs) for iGlaLixi were less vs iDeg and iDegAsp for naïve patients on 18.9 % and 28 %, and on 15.5 % and 8.9 % for insulinized patients accordingly for 26 weeks treatment. Sensitivity analysis has confirmed of results.Conclusion. iGlaLixi has economic benefits vs iDeg and iGedAsp for DM2T treatment.