Projected Cost-Effectiveness of Liraglutide, a Glucagon-Like Insulin Peptide-1
Analogue in Comparison to Insulin Glargine in Type 2 Diabetes Patients with
Suboptimal Glycaemic Control in Malaysia

Kamaruddin NA; Bidin MBL; Tan SC; Shafie AA

Abstract

Projected Cost-Effectiveness of Liraglutide, a Glucagon-Like Insulin Peptide-1 Analogue in Comparison to Insulin Glargine in Type 2 Diabetes Patients with Suboptimal Glycaemic Control in Malaysia

Objective: The objective of this study was to evaluate the long-term cost-effectiveness of liraglutide versus insulin glargine in Malaysia for obese patients with uncontrolled T2DM patients receiving 2-3 oral anti-diabetics (OADs).
Methods: The perspective of this analysis was societal. Cost-effecitveness was simulated using the validated IMS CORE Diabetes Model, with a time horizon of 40 years. Baseline characteristics of patients and treatment effectiveness was derived from LEAD5, a head-to-head trial comparing liraglutide and glargine. Published local cost data and resource use inputs were used. All costs were reported in 2014 Malaysian Ringgit (MYR). A 3% discount rate was applied. One-way and probabilistic sensitivity analyses were conducted to test the robustness of the results.
Results: The base case analysis result found that treatment with liraglutide in comparison to glargine was associated with a gain of 0.216 quality-adjusted life years (QALY) and an incremental cost of MYR12,132, resulting in an incremental cost-effectiveness ratio of MYR56,120 per QALY gained. Sensitivity analyses indicated the result wass sensitive to changes in parameters in particular number of treatment years and daily dose of liraglutide. However, none of the sensitivity analyses resulted in an ICER above the WHO’s recommended threshold of 3 times GDP per capita of Malaysia in 2014.
Conclusion: Treating poorly controlled obese T2DM patients in Malaysia with liraglutide instead of insulin glargine for an initial treatment period of up to 5 years was projected to be a cost-effective strategy resulting in beneficial outcomes, including lower rates of long-tem complications and higher quality-adjusted life expectancy.

Author(s):

Kamaruddin NA, Bidin MBL, Tan SC, Shafie AA

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