GlucosePATH is a clinically validated decision support system which creates drug regimens for patients with type 2 diabetes. Regimens are optimized for HbA1c, weight, side effect and benefit impact, adherence and cost using a composite score from 0 to 100. Used on a population level, GlucosePATH can model drug distribution for sets of clinical values, showing drug prescription frequency to that population. As new agents such as semaglutide become available, projected distribution of these options can be described at various prices. Among other things, this shows the maximum and optimal price for a new agent, given the cost and performance of existing agents.
A data set of 191 patients with HbA1c >7 was drawn from a distribution of patients cared for by PCPs in a large health system. Total monthly cost of care was computed based on the mean retail cost from the GoodRX API. Using scores drawn from GlucosePATH, drugs were redistributed to find the lowest total cost at which the population’s score was >70 of 100. Total retail cost of care averaged $475 per month per patient for the 191 patients. Redistributed medication at this price generated a mean composite score of 71.5 at a projected mean HbA1c of 6.9.
Two price points were established for ertugliflozin. The “maximal price” (MP) is the highest price at which use of the agent in the population does not exceed the control group’s retail cost of care and the composite score threshold is met. (That is, introducing the new agent does not increase cost or worsen results for the population.) The “maximal revenue” (MR) is the price at which the manufacturer maximizes their gross revenue for the agent in the population.
Price optimization for ertugliflozin showed a MP of approximately $300 (retail price: $270). At its MP, ertugliflozin would be prescribed to approximately 10% of the population with mean composite score of 76.8 and mean HbA1c 6.9. At ertugliflozin’s MR of approximately $175 per month, it would be prescribed to approximately 39% of the population and generate a mean composite score of 77.6 with a mean HbA1c of 6.9.
B. Eilerman: Speaker's Bureau; Self; AbbVie Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi, Novo Nordisk Inc., Orexigen Therapeutics, Inc., Corcept Therapeutics, Eli Lilly and Company, Merck & Co., Inc., Janssen Pharmaceuticals, Inc.. Other Relationship; Self; PATH Decision Support Software LLC. L.J. Testa: Stock/Shareholder; Self; PATH Decision Support Software LLC.