In a 4-year clinical trial in patients with type 2 diabetes (T2D), uncontrolled by metformin alone, limepiride showed a higher occurrence of cardiovascular death, non-fatal myocardial infarction (MI) and stroke compared to empagliflozin. The current modelling study aimed to extrapolate lifelong the results of the 4-year study and to assess the cost-effectiveness of empagliflozin versus glimepiride in China.
The IQVIA Core Diabetes Model, a well-established model, was calibrated to reproduce the 4-year outcomes of the trial for both arms. Baseline characteristics and observed effects on physiological parameters (HbA1c, BMI, blood pressure, lipids) were used as inputs. The effects of the trial were applied up until treatment switch (reaching HbA1c of 8.5%) after which the UKPDS82 risk equations predicted events based on physiological parameters. Insulin-glimepiride was the next line therapy after reaching an HbA1c of 8.5%. The Chinese payer’s perspective was taken. Discounting of 3% was applied.
CDM projected 11.414 and 11.137 quality-adjusted life-years (QALYs) and 42,802 USD and 42,620 USD total lifetime costs for empagliflozin and glimepiride, respectively. The incremental cost-effectiveness ratio of empagliflozin versus glimepiride was 659 USD/QALY. On average 8% of cardiovascular events can be avoided.
In patients with T2D, uncontrolled with metformin, empagliflozin has the potential to reduce the risk of cardiovascular events for a good cost-effectiveness versus glimepiride.
M. Lamotte: Employee; Self; IQVIA. Employee; Spouse/Partner; Janssen Research & Development. A. Salem: None. S.R. Mettam: Employee; Self; Boehringer Ingelheim International GmbH. A.V. Ustyugova: Employee; Self; Boehringer Ingelheim International GmbH. E. Zhang: Employee; Self; Boehringer Ingelheim China. M. Ramos: Employee; Self; IQVIA.
Boehringer Ingelheim Pharma GmbH