The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness Studies
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://revista.farmacoterapia.pt/index.php/rpf/article/view/256 |
Resumo: | ObjectiveTo conduct a systematic review of cost-effectiveness, cost-utility, and cost-benefit studies of DPP-4 inhibitors for diabetes treatment versus other antidiabetics. Methods Three investigators searched the CRD York, Tufts CEA Registry, and MEDLINE databases through 2015. We reviewed all potentially relevant titles and abstracts, and screened full-text articles, according to inclusion criteria. We established a quality score for each study based on a 35-item list. ResultsA total of 295 studies were identified, of which 20 were included. The average quality score was 0.720 on a 0–1 scale. All studies were performed in high- and middle-income countries, using a 3rd-party payer perspective and randomized clinical trials to measure effectiveness. Sitagliptin, saxagliptin and vildagliptin had an ICER below 25,000 €/QALY, as second-line and as add-ons to metformin, in comparison to sulfonylureas. When compared with sitagliptin, liraglutide (GLP-1 receptor agonist) had an ICER of up to 22,724 €/QALY for the 1.2-mg dosage, and up to 32,869 €/QALY for the 1.8-mg dosage. Insulin glargine was dominant when compared with sitagliptin. Conclusions According to the WHO threshold applied to the country and year of each study, DPP-4 inhibitors were highly cost-effective as second-line, as add-ons to metformin, in comparison with sulfonylureas. More recent therapies (GLP-1 receptor agonists and insulin glargine) were highly cost-effective in comparison to DPP-4 inhibitors. These results were obtained, however, on the basis of a limited number of studies, relying on the same few clinical trials, and financed by manufacturers. Further independent research is needed to confirm these findings. Published in: Eur J Health Econ. 2017;18:937-65. |
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The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness StudiesObjectiveTo conduct a systematic review of cost-effectiveness, cost-utility, and cost-benefit studies of DPP-4 inhibitors for diabetes treatment versus other antidiabetics. Methods Three investigators searched the CRD York, Tufts CEA Registry, and MEDLINE databases through 2015. We reviewed all potentially relevant titles and abstracts, and screened full-text articles, according to inclusion criteria. We established a quality score for each study based on a 35-item list. ResultsA total of 295 studies were identified, of which 20 were included. The average quality score was 0.720 on a 0–1 scale. All studies were performed in high- and middle-income countries, using a 3rd-party payer perspective and randomized clinical trials to measure effectiveness. Sitagliptin, saxagliptin and vildagliptin had an ICER below 25,000 €/QALY, as second-line and as add-ons to metformin, in comparison to sulfonylureas. When compared with sitagliptin, liraglutide (GLP-1 receptor agonist) had an ICER of up to 22,724 €/QALY for the 1.2-mg dosage, and up to 32,869 €/QALY for the 1.8-mg dosage. Insulin glargine was dominant when compared with sitagliptin. Conclusions According to the WHO threshold applied to the country and year of each study, DPP-4 inhibitors were highly cost-effective as second-line, as add-ons to metformin, in comparison with sulfonylureas. More recent therapies (GLP-1 receptor agonists and insulin glargine) were highly cost-effective in comparison to DPP-4 inhibitors. These results were obtained, however, on the basis of a limited number of studies, relying on the same few clinical trials, and financed by manufacturers. Further independent research is needed to confirm these findings. Published in: Eur J Health Econ. 2017;18:937-65. Formifarma2019-12-05info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://revista.farmacoterapia.pt/index.php/rpf/article/view/256Revista Portuguesa de Farmacoterapia / Portuguese Journal of Pharmacotherapy; Vol 11 No Sup 1 (2019): Suplemento 1; S25Revista Portuguesa de Farmacoterapia; v. 11 n. Sup 1 (2019): Suplemento 1; S252183-73411647-354Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://revista.farmacoterapia.pt/index.php/rpf/article/view/256http://revista.farmacoterapia.pt/index.php/rpf/article/view/256/225Direitos de Autor (c) 2019 Revista Portuguesa de Farmacoterapiahttp://creativecommons.org/licenses/by-nc-nd/4.0info:eu-repo/semantics/openAccessBaptista, ATeixeira, IRomano, SCarneiro, AVPerelman, J2023-09-01T04:34:25Zoai:ojs.farmacoterapia.pt:article/256Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:11:40.196377Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness Studies |
title |
The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness Studies |
spellingShingle |
The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness Studies Baptista, A |
title_short |
The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness Studies |
title_full |
The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness Studies |
title_fullStr |
The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness Studies |
title_full_unstemmed |
The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness Studies |
title_sort |
The Place of DPP-4 Inhibitors in the Treatment Algorithm of Diabetes Type 2: a Systematic Review of Cost-effectiveness Studies |
author |
Baptista, A |
author_facet |
Baptista, A Teixeira, I Romano, S Carneiro, AV Perelman, J |
author_role |
author |
author2 |
Teixeira, I Romano, S Carneiro, AV Perelman, J |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Baptista, A Teixeira, I Romano, S Carneiro, AV Perelman, J |
description |
ObjectiveTo conduct a systematic review of cost-effectiveness, cost-utility, and cost-benefit studies of DPP-4 inhibitors for diabetes treatment versus other antidiabetics. Methods Three investigators searched the CRD York, Tufts CEA Registry, and MEDLINE databases through 2015. We reviewed all potentially relevant titles and abstracts, and screened full-text articles, according to inclusion criteria. We established a quality score for each study based on a 35-item list. ResultsA total of 295 studies were identified, of which 20 were included. The average quality score was 0.720 on a 0–1 scale. All studies were performed in high- and middle-income countries, using a 3rd-party payer perspective and randomized clinical trials to measure effectiveness. Sitagliptin, saxagliptin and vildagliptin had an ICER below 25,000 €/QALY, as second-line and as add-ons to metformin, in comparison to sulfonylureas. When compared with sitagliptin, liraglutide (GLP-1 receptor agonist) had an ICER of up to 22,724 €/QALY for the 1.2-mg dosage, and up to 32,869 €/QALY for the 1.8-mg dosage. Insulin glargine was dominant when compared with sitagliptin. Conclusions According to the WHO threshold applied to the country and year of each study, DPP-4 inhibitors were highly cost-effective as second-line, as add-ons to metformin, in comparison with sulfonylureas. More recent therapies (GLP-1 receptor agonists and insulin glargine) were highly cost-effective in comparison to DPP-4 inhibitors. These results were obtained, however, on the basis of a limited number of studies, relying on the same few clinical trials, and financed by manufacturers. Further independent research is needed to confirm these findings. Published in: Eur J Health Econ. 2017;18:937-65. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-12-05 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://revista.farmacoterapia.pt/index.php/rpf/article/view/256 |
url |
http://revista.farmacoterapia.pt/index.php/rpf/article/view/256 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://revista.farmacoterapia.pt/index.php/rpf/article/view/256 http://revista.farmacoterapia.pt/index.php/rpf/article/view/256/225 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2019 Revista Portuguesa de Farmacoterapia http://creativecommons.org/licenses/by-nc-nd/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2019 Revista Portuguesa de Farmacoterapia http://creativecommons.org/licenses/by-nc-nd/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Formifarma |
publisher.none.fl_str_mv |
Formifarma |
dc.source.none.fl_str_mv |
Revista Portuguesa de Farmacoterapia / Portuguese Journal of Pharmacotherapy; Vol 11 No Sup 1 (2019): Suplemento 1; S25 Revista Portuguesa de Farmacoterapia; v. 11 n. Sup 1 (2019): Suplemento 1; S25 2183-7341 1647-354X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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