Original researchLiraglutide vs. sitagliptin add-on to metformin treatment for type 2 diabetes mellitus: Short-term cost-per-controlled patient in Italy

- Cost-benefit analysis to compare liraglutide vs. sitagliptin for the control of T2DM in Italy.
- The cost of control is lower for liraglutide at 26 weeks.
- The cost of control is similar for liraglutide and sitagliptin at 52 weeks.
- The cost of control is lower for sitagliptin-to-liraglutide switched patients at 78 weeks.

AimTo estimate the short-term cost-per-controlled-patient with type 2 diabetes mellitus with liraglutide 1.2 mg/day vs. sitagliptin 100 mg/day as add-on treatment to metformin in Italy.MethodsThe percentage of controlled patients, i.e. with “HbA1c < 7% without hypoglycemia and weight gain”, at 26 and 52 weeks with liraglutide and sitagliptin, as well as at 78 weeks for patients switching at 52 weeks from sitagliptin to liraglutide or hypothetically continuing on sitagliptin were obtained from randomized clinical trials (RCT) and a meta-analysis. The treatment cost-per-controlled-patient was calculated from the perspective of the National Health System over a 26, 52- and 78-week time horizon.ResultsDespite the higher acquisition cost of liraglutide vs. sitagliptin, at 26 weeks liraglutide resulted in a lower cost-per-controlled-patient (€1460 vs. €1820 - with efficacy from RCT - and €1593 vs. €2234 - with efficacy from a meta-analysis), as well as at 52 weeks (€2627 vs. €2649). At 78 weeks, in patients who have switched from sitagliptin to liraglutide at 52 weeks, the cost-per-controlled-patient is also lower than that of patients continuing sitagliptin for 78 weeks (€2889 vs. €3970).ConclusionsDue to higher efficacy, liraglutide is associated with better cost-benefit than sitagliptin at 26, 52 and 78 weeks.