Lifetime cost-effectiveness simulation of once-weekly exenatide in type 2 diabetes: A cost-utility analysis based on the EXSCEL trial
Diabetes Research and Clinical Practice — Becker F, Dakin HA, Reed SD, et al. | November 24, 2021
Once-weekly exenatide (EQW) added to usual care for treating type 2 diabetes led to increased quality-adjusted life-years (QALYs) and costs than usual care alone, in a lifetime extrapolation. The base-case incremental cost-effectiveness ratios (ICERs) were greater than the commonly-cited cost-effectiveness thresholds of $100,000/QALY and £20,000/QALY. However, considerably lower ICERs were noted in some subgroups, and in sensitivity analyses.
In the EXSCEL (Exenatide Study of Cardiovascular Event Lowering) trial, EQW vs placebo, added to usual care, was evaluated in 14,752 patients with type 2 diabetes mellitus.
In this analysis, the lifetime cost-effectiveness of adding EQW compared with usual care alone was evaluated from a healthcare perspective.
In a US setting, 0.162 QALYs were gained with EQW plus usual care at an additional cost of $41,545/patient, vs usual care.
The ICER was estimated to be $259,223/QALY.
In a UK setting, 0.151 QALYs were gained at an additional cost of £6357, providing an ICER of £42,589/QALY.
Sensitivity analyses ranged between $34,369-$269,571 and £3,430-£46,560 per QALY gained.