Cost-effectiveness and budget impact analysis of fixed combination of alogliptin and pioglitazone in the treatment of type 2 diabetes mellitus

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OBJECTIVE

To determine the optimal therapy regarding cost-effectiveness and budget impact analysis of fixed drug combination (FDC) of alogliptin and pioglitazone in the treatment of adults with diabetes mellitus (DM) type 2.

MATERIAL AND METHODS

Statistical data were obtained from the federal register of patients with DM. Only drug costs were considered in study. We used cost-minimization analysis for scenario 1 (alogliptin + pioglitazone with metformin vs. combination of alogliptin, glibenclamide and metformin) and cost-effectiveness analysis for scenario 2 (alogliptin + pioglitazone with metformin vs. combination of alogliptin and metformin). Time horizon was 3 years in budget impact analysis for current and simulated clinical practice.

RESULTS

FDC alogliptin + pioglitazone with metformin reduced annual treatment cost by 0.4% compared to combination of alogliptin, glibenclamide and metformin. Cost of FDC alogliptin 25 mg +pioglitazone 15 mg with metformin was lower by 15.2% compared to combination of alogliptin with metformin while clinical effectiveness was higher. The incremental cost-effectiveness ratio (ICER) of FDC alogliptin 25 mg + pioglitazone 30 mg with metformin was lower by 62.5% compared to combination of alogliptin with metformin. In simulated clinical practice, FDC alogliptin + pioglitazone with metformin reduce the cost by 731.6 million rubles (lower by 10.7%) throughout 3 years compared to current clinical practice for 109 768 patients.

CONCLUSION

FDC alogliptin+pioglitazone with metformin is either cost-effective or cost-caving option vs compared alternatives.

Keywords:

cost-effectiveness analysis

cost minimization analysis

budget impact

diabetes mellitus type 2

sulfonylureas

dipeptidyl-peptidase 4 inhibitors

thiazolidinediones

sodium-glucose linked transporter-2 inhibitors

Authors:

Strunina Yu.V.

Association of Specialists in Health Technology Assessment

ORCID: 0000-0002-6751-2903

Petunina N.A.

Sechenov First Moscow State Medical University

ORCID: 0000-0001-9390-1200

Received:

11.05.2023

Accepted:

08.06.2023

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