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1.
目的评价口服降糖药物联合甘精胰岛素治疗2型糖尿病的临床疗效。方法对我院67例单用口服降糖药物效果欠佳的2型糖尿病患者,于睡前加用甘精胰岛素治疗,比较治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹C肽(FCP)、餐后2 h C肽(2 h CP)、糖化血红蛋白(HbA1c)及体质量指数(BMI)等指标与低血糖发生率。结果经治疗后,患者的FPG、2 h PG和HbA1c均较治疗前明显降低,而FCP、2 h CP均较治疗前有所升高,差异均有统计学意义(P<0.05)。结论口服降糖药物联合甘精胰岛素治疗2型糖尿病疗效明显且安全性较高,患者血糖能够得到较好的控制。  相似文献   

2.
目的探讨甘精胰岛素联合二甲双胍治疗2型糖尿病的临床疗效。方法选取2型糖尿病患者66例,将其随机分为观察组和对照组各33例,观察组患者服用二甲双胍+甘精胰岛素皮下注射治疗;对照组患者仅服用二甲双胍进行治疗,两组患者治疗16周后,检测空腹血糖(FBG)、餐后2 h血糖(2 h BG)、C肽水平及糖化血红蛋白(Hb A1c)。结果两组患者经治疗后FBG、2 h BG、Hb A1c均明显下降,与治疗前比较差异有统计学意义(P<0.05),同时观察组较对照组下降明显(P<0.05)。观察组患者C肽水平明显高于对照组(P<0.05)。结论甘精胰岛素联合二甲双胍具有良好的降糖效果,同时能改善胰岛功能,减少低血糖发生,安全有效。  相似文献   

3.
目的观察格华止与甘精胰岛素联合治疗肥胖型2型糖尿病对空腹血糖、餐后2h血糖、糖化血红蛋白、体重指数的疗效。方法采用动态血糖检测对68例肥胖型2型糖尿病患者给予甘精胰岛素睡前皮下注射,同时三餐前据血糖口服格华止降糖,2~3个月后复查血糖、糖化血红蛋白、体重指数,比较治疗前后血糖、糖化血红蛋白、体重指数的变化,同时观察胰岛素用量的变化。结果格华止降低餐后高血糖明显,同时减轻体重,体重指数下降,抵消胰岛素增重的副作用,增强胰岛素的敏感性,胰岛素用量下降。甘精胰岛素弥补了患者基础胰岛素分泌不足的缺点,同时有效避免夜间低血糖的发生。结论格华止与甘精胰岛素联合治疗肥胖型2型糖尿病,患者空腹血糖、餐后2h血糖、糖化血红蛋白、体重指数均明显下降(P>0.05),胰岛素用量减少,夜间低血糖发生降低。  相似文献   

4.
目的探讨奥曲肽联合凝血酶用于治疗门静脉高压症伴消化道出血患者的疗效及对心血管不良事件的影响。方法选取2018年2月至2019年2月辽阳市太子河区医院收治的86例门静脉高压症伴消化道出血患者作为研究对象,按照入院时间采用随机数字表法分为对照组和观察组,各43例。对照组患者采用奥曲肽治疗,观察组患者采用奥曲肽联合凝血酶治疗,比较两组患者治疗效果、血小板计数、白细胞计数、输血量、止血时间、住院时间以及对心血管不良事件的影响。结果治疗前,两组患者血小板计数以及白细胞计数比较差异无统计学意义(P>0.05);治疗后,两组患者血小板计数和白细胞计数升高,且观察组高于对照组,差异有统计学意义(P<0.05);观察组输血量少于对照组,止血时间以及住院时间短于对照组,差异有统计学意义(P<0.05);观察组患者治疗有效率为95.35%,明显高于对照组的81.39%,差异有统计学意义(P<0.05);随访1年观察组患者心血管不良事件发生率明显低于对照组(P<0.05)。结论奥曲肽联合凝血酶用于治疗门静脉高压症伴消化道出血患者的疗效更显著,心血管不良事件的发生率也大幅度降低,缩短了治疗时间,减轻了患者经济负担,安全性更高。  相似文献   

5.
目的观察还原型谷光甘肽抢救治疗双硫仑样反应疗效及安全性。方法将我院2012年1月~2013年2月急救治疗的88例双硫仑反应患者,随机分为治疗组和对照组,治疗组用还原型谷光甘肽1200mg+生理盐水100ml静脉滴注;两组其它一般性基础治疗相同,观察用药后两组症状缓解快慢。结果治疗组缓解症状较对照组快,无明显副作用。结论还原型谷光甘肽抢救治疗双硫仑样反应见效快,不良反应少,安全可靠。  相似文献   

6.
目的 对应用奥曲肽与生长抑素对患有肝硬化上消化道出血的患者进行治疗的临床效果进行比较分析.方法 抽取86 例患有肝硬化上消化道出血的临床确诊患者病例,将其分为A、B 两组,平均每组43 例.A 组患者生长抑素进行治疗;B 组患者采用奥曲肽进行治疗.结果 B 组患者治疗后的症状改善情况明显优于A 组患者;该组患者治疗结束后病情复发率明显低于A 组患者;两组患者治疗过程中,没有出现任何不良反应.结论 应用奥曲肽对患有肝硬化上消化道出血的患者进行治疗的临床效果非常明显.  相似文献   

7.
目的:探讨奥曲肽治疗肝硬化上消化道出血的临床效果。方法选取我院2009年11月至2013年11月期间诊治的肝硬化上消化道出血新农合住院患者56例为研究对象,将其采用随机分组的方式分为观察组与对照组,每组28例。对照组患者采用常规补充血容量、止血抑酸治疗,观察组在对照组治疗的基础上加用奥曲肽治疗,对两组患者的治疗效果及不良反应发生情况进行分析对比。结果本组研究结果显示,观察组患者平均止血时间、输血量明显少于对照组,差异有统计学意义(P<0.05);观察组中有3例患者出现继发感染,对照组中有4例患者出现继发感染,两组患者并发症发生情况比较,差异无统计学意义(P>0.05)。结论奥曲肽治疗肝硬化上消化道出血具有良好的临床效果,能有效缩短患者的止血时间,减少输血量。  相似文献   

8.
目的观察甘露聚糖肽联合尿激酶在治疗恶性胸腔积液中的疗效。方法将58例恶性胸腔患者随机分组,治疗组30例,对照组28例。对照组常规顺铂治疗,治疗组采用甘露聚糖肽联合尿激酶腔内给药治疗。结果治疗组有效率(83.3%),高于对照组的60.7%,差异有统计学意义(P<0.05);治疗组体力状态 KPS 评分好转率(73.3%),高于对照组的35.7%,差异有统计学意义(P<0.005)。治疗组4例患者治疗期间出现发热,为低热,3例患者出现轻度胸痛,及时服用解热镇痛药物后,病情得到了有效治疗。治疗组患者的肝功能、肾功能、血常规均正常,没有1例出现出血、积液包裹、积液分隔的情况,也没有出现毒副反应或过敏反应,而对照组出现多例不良反应,如发热、胸痛、骨髓抑制、胃肠道反应等。结论甘露聚糖肽联合尿激酶胸腔内注射治疗恶性胸腔积液疗效显著,不良反应小,易为患者所接受,明显提高患者生活质量,值得临床推广应用。  相似文献   

9.
目的探讨对糖尿病患者使用预混胰岛素以及普通胰岛素加睡前胰岛素的强化治疗糖尿病的临床效果。方法选68例2型糖尿病患者,按照随机的方法将2型糖尿病患者分成实验组和对照组,对实验组患者应用三餐前注射预混胰岛素的方法强化治疗,对照组采用普通胰岛素加睡前胰岛素的方法进行强化治疗,疗程为六个月,研究治疗后糖化血红蛋白、空腹血糖、饭后2h血糖、两天血糖平均水平、血糖达标的时间、低血糖发生率、住院时间、胰岛素使用量以及低血糖后不良反应发生率等指标。结果实验组饭后2h血糖水平较对照组高,P>0.05,不存在显著性差异;治疗后两组血糖均达标,但是实验组的达标时间显然更短,且P<0.05,存在显著性差异;空腹血糖、两天内血糖平均水平指标实验组均低于对照组,其P<0.05,存在显著性差异;实验组低血糖发生率、住院时间、胰岛素的使用量以及低血糖后不良反应发生率指标均较对照组低,P<0.05,存在显著性差异。结论应用预混胰岛素强化治疗糖尿病的方法比应用普通胰岛素加睡前胰岛素的强化治疗糖尿病方法效果好,并且恢复时间短,不良事件发生率低,值得人们反复研究以及推广。  相似文献   

10.
目的探讨糖毒宁方对2型糖尿病患者胰岛素抵抗的影响。方法将入选的80例2型糖尿病患者随机分为治疗组和对照组各40例,治疗组采用糖毒宁方治疗,对照组服用吡格列酮片治疗,治疗前、后观察血糖、血脂、胰岛素、胰岛素抵抗指数、CRP水平变化情况。结果治疗组的总有效率以及改善糖脂紊乱、提高C肽水平、降低胰岛素抵抗指数、CRP等方面均优于对照组,差异具有显著性(P<0.05)。结论糖毒宁方能明显改善2型糖尿病胰岛素抵抗状态。  相似文献   

11.
Aims: Bringing patients with type 2 diabetes to recommended glycated hemoglobin (HbA1c) treatment targets can reduce the risk of developing diabetes-related complications. The aim of the present analysis was to evaluate the short-term cost-effectiveness of once-daily liraglutide 1.8?mg vs once-daily lixisenatide 20?μg as an add-on to metformin for treatment of type 2 diabetes in the US by assessing the cost per patient achieving HbA1c-focused and composite treatment targets.

Materials and methods: Percentages of patients achieving recommended targets were obtained from the LIRA-LIXI trial, which compared the efficacy and safety of once-daily liraglutide 1.8?mg and once-daily lixisenatide 20?μg as an add-on to metformin in patients with type 2 diabetes failing to achieve glycemic control with metformin. Annual costs were estimated from a healthcare payer perspective. An economic model was developed to evaluate the annual cost per patient achieving target (cost of control) with liraglutide 1.8?mg vs lixisenatide 20?μg for five end-points.

Results: Annual treatment costs were higher with liraglutide 1.8?mg than lixisenatide 20?μg, but this was offset by greater clinical efficacy, and the cost of control was lower with liraglutide 1.8?mg than lixisenatide 20?μg for all five end-points. The annual cost of control was USD 3,850, USD 11,404, USD 3,807, USD 4,299, and USD 6,901 lower for liraglutide 1.8?mg than lixisenatide 20?μg for targets of HbA1c?Conclusions: Once-daily liraglutide 1.8?mg was associated with greater clinical efficacy than once-daily lixisenatide 20?μg, which resulted in a lower annual cost of control for HbA1c-focused and composite treatment targets.  相似文献   

12.
Abstract

Objective:

The safety and efficacy of the GLP-1 receptor agonists exenatide BID (exenatide) and liraglutide for treating type 2 diabetes mellitus (T2DM) have been established in clinical trials. Effective treatments may lower overall treatment costs. This study examined cost offsets and medication adherence for exenatide vs liraglutide in a large, managed care population in the US.

Methods:

This was a retrospective cohort analysis comprising adult patients with T2DM who initiated exenatide or liraglutide between 1/1/2010 and 6/30/2010 and had 6 months pre-index and post-index continuous eligibility. Patients were propensity score-matched to controls for baseline differences. Medication adherence was measured by proportion of days covered (PDC). Paired t-test and McNemar’s test were used to compare outcomes.

Results:

Matched exenatide and liraglutide cohorts (n?=?1347 pairs) had similar average total 6-month follow-up costs ($6688 vs $7346). However, exenatide patients had significantly lower mean pharmacy costs ($2925 vs $3272, p?<?0.001). Among liraglutide patients, patients receiving the 1.8?mg dose had significantly higher average total costs compared to those receiving the 1.2?mg dose ($8031 vs $6536, p?=?0.026), with higher mean pharmacy costs in the 1.8?mg cohort ($3935 vs $3146, p?<?0.001). There were no significant differences in inpatient or outpatient costs or medication adherence between groups (mean PDC: exenatide 56% vs liraglutide 57%, p?=?0.088).

Limitations:

The study assumed that all information needed for case classification and matching of cohorts was present and not differential across cohorts. The study did not control for covariates that were unavailable, such as HbA1c and duration of diabetes.

Conclusions:

Patients initiating exenatide vs liraglutide for T2DM had similar medication adherence and total healthcare costs; however, exenatide patients had significantly lower total pharmacy costs. Patients prescribed 1.8?mg liraglutide had significantly higher costs compared to those on 1.2?mg.  相似文献   

13.
Abstract

Objective:

To compare the cost-utility of exenatide once weekly (EQW) and insulin glargine in patients with type 2 diabetes in the United Kingdom (UK).

Research design and methods:

The IMS CORE Diabetes Model was used to project clinical and economic outcomes for patients with type 2 diabetes treated with EQW or insulin glargine. Treatment effects and patient baseline characteristics (mean age: 58 years, mean glycohaemoglobin: 8.3%) were taken from the DURATION-3 study. Unit costs and health state utility values were derived from published sources. As the price of EQW is not yet known, the prices of two currently available glucagon-like peptide-1 products were used as benchmarks. To reflect diabetes progression, patients started on EQW switched to insulin glargine after 5 years. The analysis was conducted from the perspective of the UK National Health Service over a time horizon of 50 years with costs and outcomes discounted at 3.5%. Sensitivity analyses explored the impact of changes in input data and assumptions and investigated the cost utility of EQW in specific body mass index (BMI) subgroups.

Main outcome measures:

Incremental cost-effectiveness ratio (ICER) for EQW compared with insulin glargine.

Results:

At a price equivalent to liraglutide 1.2?mg, EQW was more effective and more costly than insulin glargine, with a base case ICER of £10,597 per quality-adjusted life-year (QALY) gained. EQW was associated with an increased time to development of any diabetes-related complication of 0.21 years, compared with insulin glargine. Three BMI subgroups investigated (<30, 30–35 and >35?kg/m2) reported ICERs for EQW compared with insulin glargine ranging from £9425 to £12,956 per QALY gained.

Conclusions:

At the prices investigated, the cost per QALY gained for EQW when compared with insulin glargine in type 2 diabetes in the UK setting, was within the range normally considered cost effective by NICE. Cost effectiveness in practice will depend on the final price of EQW and the extent to which benefits observed in short-term randomised trials are replicated in long-term use.  相似文献   

14.
Abstract

Aim:

The aim of this analysis was to investigate total healthcare costs, HbA1c, and weight changes over a 36-month period in patients with type 2 diabetes initiated on NPH or long-acting insulin analogs.

Methods:

Electronic patient data from 479 general practices in the UK (THIN database) were examined for new users of glargine (n?=?794), detemir (n?=?252), or NPH insulin (n?=?430). Annualized healthcare costs and clinical outcomes in years 1, 2, and 3 following insulin initiation were quantified and compared with baseline, using ANOVA and linear regression models.

Results:

A significant difference (p?<?0.05) in total healthcare costs increases at year 1 vs baseline was observed between glargine and detemir, detemir and NPH, but not between glargine and NPH (increase: +£486, +£635, and +£420 for glargine, detemir, and NPH users, respectively). However, increases by year 3 were not significantly different between the insulins. A propensity score analysis comparing analog and NPH insulin showed that, following insulin initiation, increases in costs were higher with insulin analogs at year one (+£220), but this difference decreased over time in each year following insulin initiation (+£168 and +£146, respectively, for years 2 and 3). HbA1c reductions were not significantly different between the groups at all time points. Differences in weight gain between glargine and NPH were statistically significant at year 1 (0.87?kg vs 1.11?kg) and year 3 (1.15?kg vs 1.57?kg), but other estimates of between-group differences in weight gain were non-significant.

Conclusions:

Following insulin initiation, the difference in healthcare costs of long-acting analogs compared to NPH insulin was transient. By year 3, the cost differences were not significantly different between the two cohorts, driven by an observed reduction in the cost of self-monitoring of blood glucose (SMBG) in the analog group and an increase in the cost of bolus insulin in the NPH group.  相似文献   

15.
Abstract

Aims: The efficacy and safety of oral semaglutide, the first glucagon-like peptide-1 (GLP-1) receptor agonist developed for oral administration for the treatment of type 2 diabetes, was evaluated in the PIONEER clinical trial program, and a recently published network meta-analysis allowed comparison with further injectable GLP-1 receptor agonists. The present study aimed to assess the short-term cost- effectiveness of oral semaglutide 14?mg versus subcutaneous once-weekly dulaglutide 1.5?mg, once-weekly exenatide 2?mg, twice-daily exenatide 10?µg, once-daily liraglutide 1.8?mg, once-daily lixisenatide 20?µg, and once-weekly semaglutide 1?mg, in terms of the cost per patient achieving glycated hemoglobin (HbA1c) targets (cost of control).

Materials and methods: Cost of control was calculated by dividing the annual treatment costs associated with an intervention by the proportion of patients achieving the treatment target with an intervention, with outcomes calculated for targets of HbA1c ≤6.5% and HbA1c <7.0% for all included GLP-1 receptor agonists. Annual treatment costs were accounted in 2019 United States dollars (USD), based on 2019 wholesale acquisition cost.

Results: For the treatment target of HbA1c ≤6.5%, once-weekly semaglutide 1?mg and oral semaglutide 14?mg were associated with the lowest costs of control, at USD 15,430 and USD 17,383 per patient achieving target, respectively. Similarly, the cost of control was lowest with once-weekly semaglutide 1?mg at USD 12,627 per patient achieving target, followed by oral semaglutide 14?mg at USD 13,493 per patient achieving target for the target of HbA1c <7.0%. All other interventions were associated with higher cost of control values for both targets.

Conclusions: Oral semaglutide 14?mg is likely to be cost-effective versus dulaglutide, exenatide (once weekly and twice daily), liraglutide, and lixisenatide in terms of bringing people with type 2 diabetes to glycemic control targets of HbA1c ≤6.5% and HbA1c <7.0% in the US.  相似文献   

16.
Objectives: This study investigated the cost per responder and number needed to treat (NNT) in type 2 diabetes mellitus (T2DM) patients for lixisenatide compared to insulin intensification regimens using composite endpoints in the UK, Italy, and Spain.

Methods: Efficacy and safety outcomes were obtained from GetGoal Duo-2, a 26-week phase 3 trial comparing lixisenatide vs insulin glulisine (IG) once daily (QD) and three times daily (TID). Response at week 26 was extrapolated to 52 weeks, assuming a maintained treatment effect, based on long-term evidence in other T2DM populations. Responders were defined using composite end-points, based on an HbA1c threshold and/or no weight gain and/or no hypoglycemia. The HbA1c threshold was varied in sensitivity analyses. Annual treatment costs were estimated in euros (1 GBP?=?1.26 EUR), including drug acquisition and resource use costs. Cost per responder was computed by dividing annual treatment costs per patient by the proportion of responders.

Results: Lixisenatide was associated with the lowest cost per responder for all composite end-points that included a weight-related component. For the main composite end-point of HbA1c ≤7.5% AND no weight gain AND no symptomatic hypoglycemia, cost per responder results were: UK: 6,867€, 8,746€, and 12,410€; Italy: 7,057€, 9,160€, and 12,844€; Spain: 8,370€, 11,365€, and 17,038€, for lixisenatide, IG QD, and TID, respectively. The NNT analysis showed that, for every 6.85 and 5.86 patients treated with lixisenatide, there was approximately one additional responder compared to IG QD and TID, respectively.

Limitations: A limitation of the clinical inputs is the lack of 52-week trial data from GetGoal Duo-2, which led to the assumption of a maintained treatment effect from week 26 to 52.

Conclusions: This analysis suggests lixisenatide is an efficient economic resource allocation in the UK, Italy, and Spain.  相似文献   

17.
Abstract

Objectives:

This study evaluated patient and prescriber characteristics, treatment patterns, average daily dose (ADD), and glycemic control of patients initiating glucagon-like peptide 1 (GLP-1) receptor agonists in Germany.

Methods:

The LifeLink? EMR-EU database was searched to identify patients initiating exenatide twice daily (BID) or liraglutide once daily (QD) during the index period (January 1, 2009–April 4, 2010). Eligible patients had ≥180 days pre-index history, ≥90 days post-index follow-up, and a pre-index type 2 diabetes diagnosis. Univariate tests were conducted at α?=?0.05.

Results:

Six hundred and ninety-two patients were included (exenatide BID 292, liraglutide QD 400): mean (SD) age 59 (10) years, 59% male. Diabetologists prescribed liraglutide QD to a larger share of patients (65% vs 35% exenatide BID) than non-diabetologists (51% vs 49%). GLP-1 receptor agonist choice was not associated with age (p?=?0.282), gender (p?=?0.960), number of pre-index glucose-lowering medications (2.0 [0.9], p?=?0.159), pre-index HbA1c (8.2 [1.5%], p?=?0.231) or Charlson Comorbidity Index score (0.45 [0.78], p?=?0.547). Mean (SD) ADD was 16.7?mcg (9.2, label range 10–20?mcg) for exenatide BID and 1.4?mg (0.7, label range 0.6–1.8?mg) for liraglutide QD. Among patients with post-index HbA1c tests, mean unadjusted values did not differ between cohorts. Exenatide BID patients were more likely than liraglutide QD patients to continue pre-index glucose-lowering medications (67.1% vs 60.3%, p?=?0.027) or to start concomitant glucose-lowering medications at index (32.2% vs 25.0%, p?=?0.013); exenatide BID patients were less likely to augment treatment with another drug post-index (15.8% vs 22.5%, p?=?0.027).

Limitations:

Results may not be generalizable. Lab measures for clinical outcomes were available only for a sub-set of patients.

Conclusions:

Results suggested that some differences exist between patients initiating exenatide BID or liraglutide QD, with respect to prescribing physician specialty and pre- and post-index treatment patterns. Both GLP-1 receptor agonists showed comparable post-index HbA1c values in a sub-set of patients.  相似文献   

18.
Objective: To evaluate the cost-effectiveness of exenatide twice daily (BID) vs bolus insulin lispro three times daily (TID) as add-on therapy when glycemic control is sub-optimal with titrated basal insulin glargine and metformin.

Methods: The analysis was based on the recent 4B Study, which compared exenatide BID and lispro TID as add-on therapies in subjects with type 2 diabetes insufficiently controlled, despite titrated insulin glargine. The Cardiff Diabetes Model was used to simulate patient costs and health benefits beyond the 4B Study. The Swedish healthcare perspective was adopted for this analysis; costs are reported in €EUR to aid interpretation. The main outcome measure was the cost per quality-adjusted life-year (QALY) gained with exenatide BID compared to lispro TID.

Results: Exenatide BID was associated with an incremental cost of €1,270 and a QALY increase of +0.64 compared with lispro TID over 40 years. The cost per QALY gained with exenatide BID compared with lispro TID was €1,971, which is within conventional limits of cost-effectiveness. Cost-effectiveness results were generally robust to alternative assumptions and values for key model parameters.

Limitations: Extrapolation of trial data over the longer term can be influenced by modeling and parameter uncertainty. Cost-effectiveness results were generally insensitive to alternative values of key model input parameters and across scenarios.

Conclusions: The addition of exenatide BID rather than insulin lispro to basal insulin is associated with similar or better clinical outcomes. Illustrated from the Swedish healthcare perspective, analysis with the Cardiff Diabetes Model demonstrated that exenatide BID represents a cost-effective treatment alternative to lispro TID as add-on therapy in type 2 diabetes patients insufficiently controlled on basal insulin.  相似文献   


19.
Objectives:

The present study aimed to compare the projected long-term clinical and cost implications associated with liraglutide, sitagliptin and glimepiride in patients with type 2 diabetes mellitus failing to achieve glycemic control on metformin monotherapy in France.

Methods:

Clinical input data for the modeling analysis were taken from two randomized, controlled trials (LIRA-DPP4 and LEAD-2). Long-term (patient lifetime) projections of clinical outcomes and direct costs (2013 Euros; €) were made using a validated computer simulation model of type 2 diabetes. Costs were taken from published France-specific sources. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed.

Results:

Liraglutide was associated with an increase in quality-adjusted life expectancy of 0.25 quality-adjusted life years (QALYs) and an increase in mean direct healthcare costs of €2558 per patient compared with sitagliptin. In the comparison with glimepiride, liraglutide was associated with an increase in quality-adjusted life expectancy of 0.23 QALYs and an increase in direct costs of €4695. Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio (ICER) of €10,275 per QALY gained vs sitagliptin and €20,709 per QALY gained vs glimepiride in France.

Conclusion:

Calculated ICERs for both comparisons fell below the commonly quoted willingness-to-pay threshold of €30,000 per QALY gained. Therefore, liraglutide is likely to be cost-effective vs sitagliptin and glimepiride from a healthcare payer perspective in France.  相似文献   

20.
Objective: To assess the cost-effectiveness of exenatide 2?mg once-weekly (EQW) compared to dulaglutide 1.5?mg QW, liraglutide 1.2?mg and 1.8?mg once-daily (QD), and lixisenatide 20?μg QD for the treatment of adult patients with type 2 diabetes mellitus (T2DM) not adequately controlled on metformin.

Methods: The Cardiff Diabetes Model was applied to evaluate cost-effectiveness, with treatment effects sourced from a network meta-analysis. Quality-adjusted life years (QALYs) were calculated with health-state utilities applied to T2DM-related complications, weight changes, hypoglycemia, and nausea. Costs (GBP £) included drug treatment, T2DM-related complications, severe hypoglycemia, nausea, and treatment discontinuation due to adverse events. A 40-year time horizon was used.

Results: In all base-case comparisons, EQW was associated with a QALY gain per patient; 0.046 vs dulaglutide 1.5?mg; 0.102 vs liraglutide 1.2?mg; 0.043 vs liraglutide 1.8?mg; and 0.074 vs lixisenatide 20?μg. Cost per patient was lower for EQW than for liraglutide 1.8?mg (?£2,085); therefore, EQW dominated liraglutide 1.8?mg. The cost difference per patient between EQW and dulaglutide 1.5?mg, EQW and liraglutide 1.2?mg, and EQW and lixisenatide 20?μg was £27, £103, and £738, respectively. Cost per QALY gained with EQW vs dulaglutide 1.5?mg, EQW vs liraglutide 1.2?mg, and EQW vs lixisenatide 20?μg was £596, £1,004, and £10,002, respectively. In the probabilistic sensitivity analysis, the probability that EQW is cost-effective ranged from 76–99%.

Conclusion: Results suggest that exenatide 2?mg once-weekly is cost-effective over a lifetime horizon compared to dulaglutide 1.5?mg QW, liraglutide 1.2?mg QD, liraglutide 1.8?mg QD, and lixisenatide 20?μg QD for the treatment of T2DM in adults not adequately controlled on metformin alone.  相似文献   

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