TY - JOUR T1 - Cost-effectiveness of exenatide versus insulin glargine in Spanish patients with obesity and type 2 diabetes mellitus JO - Endocrinología y Nutrición (English Edition) T2 - AU - Goodall,Gordon AU - Costi,María AU - Timlin,Louise AU - Reviriego,Jesús AU - Sacristán,José Antonio AU - Smith-Palmer,Jayne AU - Dilla,Tatiana SN - 21735093 M3 - 10.1016/j.endoen.2011.04.002 DO - 10.1016/j.endoen.2011.04.002 UR - https://www.elsevier.es/en-revista-endocrinologia-nutricion-english-edition--412-articulo-cost-effectiveness-exenatide-versus-insulin-glargine-S2173509311000092 AB - Background and objectivesExenatide, a GLP-1 receptor agonist for adjuvant treatment of type 2 diabetes mellitus (T2DM), has been shown to be as effective as insulin glargine (IG) for reducing glycated hemoglobin levels combined with metformin or/and sulfonylureas. Exenatide is associated to weight reduction and a higher incidence of gastrointestinal adverse events.The objective of this study was to assess the cost-effectiveness of exenatide as compared to IG in obese patients with T2DM not achieving an adequate blood glucose control from the perspective of the Spanish healthcare system. MethodsPharmacoeconomic model inputs were obtained from an obese subpopulation (BMI≥30kg/m2) of an international, randomized, controlled clinical trial comparing exenatide with IG in poorly controlled T2DM patients, and were supplemented with country-specific data. ResultsExenatide was associated to improvements in life-years gained and quality-adjusted life years (QALYs) by 0.11 and 0.62, respectively, versus IG. Direct costs were €9306 higher as compared to IG (€47,010 versus €37,704, with increased pharmacy costs as the main driver). Exenatideís incremental cost-effectiveness ratio was €15,068 per QALY gained versus IG. ConclusionsExenatide was associated to greater clinical benefits and higher costs in obese T2DM patients as compared to IG. Considering a willingness-to-pay threshold of €30,000 per QALY gained in the Spanish setting, exenatide represents an efficient option in comparison with IG. ER -