Cost-Effectiveness of Newer Pharmacologic Treatments in Adults with Type 2 Diabetes: Systematic Review of Cost-Effectiveness Studies for the American College of Physicians
2024
This systematic review examines the cost-effectiveness of newer antidiabetes medications for type 2 diabetes in the United States. The study screened nonindustry-funded cost-effectiveness analyses (CEAs) conducted from 2010 to 2023, focusing on estimating cost per quality-adjusted life-year (QALY) gained. Nine CEAs met the criteria, evaluating medications such as glucagon-like peptide-1 agonists (GLP1a), dipeptidyl peptidase-4 inhibitors (DPP4i), and sodium–glucose cotransporter-2 inhibitors (SGLT2i), among others. Comparisons were made against metformin, sulfonylureas, neutral protamine Hagedorn (NPH) insulin, and others. GLP1a and SGLT2i were deemed of low value as first-line therapy but of intermediate value when added to metformin or other background therapy. Insulin analogues were found to be similarly effective but more costly than NPH insulin. The value of GIP/GLP1a remained uncertain due to insufficient evidence. Limitations include variations in methodological approaches among CEAs and the lack of well-established criteria for assessing risk of bias and certainty of evidence in CEAs. This review underscores the sensitivity of results to assumptions regarding drug effectiveness and costs.
Source:
Schousboe JT, Landsteiner A, Drake T et al. Cost-Effectiveness of Newer Pharmacologic Treatments in Adults With Type 2 Diabetes: A Systematic Review of Cost-Effectiveness Studies for the American College of Physicians. Annals of Internal Medicine 2024. https://doi.org/10.7326/M23-1492