Cost-effectiveness of saxagliptin (Onglyza®) in type 2 diabetes in Sweden

Aim: The objective of this study was to investigate the cost-effectiveness of saxagliptin (Onglyza (R)), a DPP-4 inhibitor, plus metformin compared with a sulphonylurea (SU) (Glipizide) plus metformin in Swedish patients not well controlled on metformin alone. Methods: Data from a 52-week clinical trial comparing saxagliptin and glipizide in combination with metformin was used in a simulation model to estimate long term complications in a cohort of type 2 diabetes patients. The model estimates the incidence of microvascular and macrovascular complications, diabetes-specific mortality, all-cause mortality, and ultimately, costs and quality-adjusted life years (QALYs) associated with the investigated treatment strategies. Costs and QALYs were estimated for a lifetime time horizon. Results: Compared with SU + metformin, the cost per QALY gained with saxagliptin + metformin is approximately SEK 91,000. Patients on saxagliptin + metformin gain 0.10 QALYs on average, at an incremental cost of around SEK 9500. The cost-effectiveness results were robust to various sensitivity analyses. Conclusions: This study demonstrates that, over a patient's lifetime, the addition of saxagliptin to metformin is associated with improvements in quality-adjusted life years compared with SU in patients with type 2 diabetes. Saxagliptin treatment is a cost-effective treatment alternative for type 2 diabetes in patients not well-controlled on metformin alone. (C) 2011 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.