Estimating the Long-Term Cost-Effectiveness of Exenatide in the United States: An Adjunctive Treatment for Type 2 Diabetes Mellitus

This analysis provides an early estimate of the cost-effectiveness of adjunctive exenatide in treating type 2 diabetes mellitus in the United States. Data from pivotal phase III 30-week clinical trials and 52 weeks of their subsequent open-label extension studies (i.e., 82 weeks total) were used to...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Value in health Jg. 11; H. 1; S. 22 - 33
Hauptverfasser: Minshall, Michael E., Oglesby, Alan K., Wintle, Matthew E., Valentine, William J., Roze, Stéphane, Palmer, Andrew J.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Malden, USA Elsevier Inc 2008
Blackwell Publishing Inc
Schlagworte:
BYETTA
Clinical trials
Cost effectiveness
Cost-Benefit Analysis
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - economics
Drug Costs
exenatide
Glycated Hemoglobin A - drug effects
Health Care Costs
Humans
Hypoglycemic Agents - economics
Hypoglycemic Agents - therapeutic use
Internal Medicine
Lipids
Metformin
modeling
Models, Econometric
Monte Carlo Method
Peptides - economics
Peptides - therapeutic use
Sensitivity analysis
Sulfonylurea Compounds
Time Factors
type 2 diabetes
Type 2 diabetes mellitus
United States
Venoms - economics
Venoms - therapeutic use
cost-effectiveness
modeling
type 2 diabetes
BYETTA
exenatide
ISSN:1098-3015, 1524-4733, 1524-4733
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:This analysis provides an early estimate of the cost-effectiveness of adjunctive exenatide in treating type 2 diabetes mellitus in the United States. Data from pivotal phase III 30-week clinical trials and 52 weeks of their subsequent open-label extension studies (i.e., 82 weeks total) were used to project the effects of 30 years of adjunctive exenatide treatment. This analysis utilized a published and validated Markov model incorporating Monte Carlo simulation with tracker variables to estimate the clinical and cost outcomes of adding exenatide to a background of metformin and/or sulfonylurea treatment, with the effects of 30 years of adjunctive exenatide treatment (projected from data from 82 weeks of exenatide treatment) compared with no additional treatment beyond metformin and/or a sulfonylurea. Sensitivity analyses were performed on key clinical assumptions, discount rates, and shorter time horizons. The base-case scenario (30 years of exenatide) yielded an incremental cost-effectiveness ratio (ICER) of $35,571. We found that shortening the time horizons and removing the lipid effects of exenatide had the greatest negative impact on ICERs when performing sensitivity analysis. Our analysis demonstrated that exenatide used for 20 or 30 years compared with no additional treatment beyond metformin and/or a sulfonylurea is cost-effective in the adjunctive treatment of type 2 diabetes with an ICER less than $50,000 per life-year gained. Sensitivity analyses suggest that, in addition to sustained reduction in HbA 1c, the added clinical effects of improved lipid values, systolic blood pressure, and reduced body mass index all positively contributed to the cost-effectiveness of exenatide.
Bibliographie:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ObjectType-Article-1
ObjectType-Feature-2
ISSN:1098-3015
1524-4733
1524-4733
DOI:10.1111/j.1524-4733.2007.00211.x