Качественная клиническая практика (May 2018)
Pharmacoeconomic analysis of use the oral hypoglycemic agents in patients with type 2 diabetes mellitus according to a real clinical practice
Abstract
We aimed to conduct cost-utility analysis of two different regimens of the oral hypoglycemic therapy in 2 type diabetes mellitus (DM2). Methods. In the whole, 229 patients with DM2, receiving vildagliptin add-on to metformin (group 1) or sulphonylureas add-on to metformin (group 2) were enrolled in the study. Cost-utility ratio (CUR) was identified as a ratio of difference in total costs of treatment in the groups and difference in QALY in corresponding groups. The overall costs included direct costs of treatment as well as costs for treating of DM2 complications (severe hypoglycemia) and the costs related to the loss of GDP due to severe hypoglycemia events. Health utility value was evaluated for each patient on the basis of SF-6D questionnaire. Pharmacoeconomic expediency of treatment regimen was estimated by means of comparing the CUR and wiliness-to-pay ratio (WTP) for Russian Federation (RF). Results. The health utility value was higher in group 1 as compared to group 2: 0,757 vs 0,70 (p>0,05). The overall costs for treating one patient in group 1 during a year were 28 637,34 rubles, in group 2 - 10 231,55 rubles. CUR amounted 328 674,82 rubles and it was 4.4 times lower than upper border of WTP ratio in RF (1 457 400 rub.). Conclusion. The innovation treatment regimen with vildagliptin add-on to metformin is beneficial and may be considered as economically reasonable alternative to traditional treatment regimen with sulphonylureas add-on to metformin for DM2 patients in RF.
