Cost-effectiveness of Empagliflozin Compared to Liraglutide in Iran Based on Cardiovascular Outcome Trials in Type 2 Diabetes Mellitus
Empagliflozin Coat-effectiveness in Iranian Diabetic Patients
Abstract
Background: Empagliflozin and liraglutide are anti-hyperglycemic agents with proven cardiovascular benefits in Type 2 Diabetes Mellitus (T2DM) patients with established Cardiovascular (CV) disease. Although both drugs are available in Iran’s pharmaceutical market, no local or regional study has analyzed the cost-effectiveness of these drugs in terms of reduction in the rate of CV-related mortality in T2DM patients in this country. In the present study, a one-year Cost-Effectiveness Analysis (CEA) was conducted based on decision-analytic modeling to compare the effectiveness of empagliflozin versus liraglutide in the prevention of CV-related death in T2DM patients in Iran.Methods: A one-year CEA was performed to compare the effects of empagliflozin in contrast to liraglutide on the prevention of CV-related mortality from the Iranian T2DM payers’ perspective. Clinical data were extracted from the results of LEADER and EMPA-REG OUTCOME studies. Economical and cost data were taken from the FDA official website of Iran (http://irc.fda.gov.ir/nfi) and the national book of tariffs. The data then were converted to the 2021-USD using governmental conversion rates and presented in terms of Incremental Cost-Effectiveness Ratio (ICER). In order to assess the robustness of the results, scenario analysis and multiple Deterministic Sensitivity Analysis (DSA) were also performed.Results: Empagliflozin dominated original brand liraglutide and biosimilar liraglutide with reduced costs in preventing one extra CV-related death in T2DM patients. The annual cost was $30,585 (95%CI: $22,283- $48,745), $736,179 (95%CI: $457,206- $2,286,029), and $445,512 (95%CI: 276,686- 1,383,432) for empagliflozin, original brand liraglutide, and biosimilar liraglutide, respectively. These results were in line with the findings from scenario, base-case and deterministic sensitivity analyses.Conclusion: Empagliflozin is projected to be highly cost-effective in terms of the prevention of CV-related death compared to liraglutide in Iran.International Diabetes Federation. IDF Diabetes Atlas. Brussels: International Diabetes Federation; 2019. https://diabetesatlas.org/idfawp/resourceiles/2019/07/IDF_diabetes_atlas_ninth_edition_en.pdf
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| Issue | Vol 8 No 1/2 (2022) | |
| Section | Original Article(s) | |
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| Empagliflozin Liraglutide Cardiovascular Mortality Diabetes Cost-Effectiveness Analysis. | ||
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