Evidence map›Paper›PMID 25213800›Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2014

Cost-utility analysis of glucagon-like Peptide-1 agonists compared with dipeptidyl peptidase-4 inhibitors or neutral protamine hagedorn Basal insulin as add-on to metformin in type 2 diabetes in sweden.

Aliasghar A Kiadaliri, Ulf G Gerdtham, Bjorn Eliasson, Katarina Steen Carlsson

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 5 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 5 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
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  5. The place of DPP-4 inhibitors in the treatment algorithm of diabetes type 2: a systematic review of cost-effectiveness studies.The European journal of health economics : HEPAC : health economics in prevention and care · 2017
    Pooled it
  6. Review
  7. Article
  8. Review
  9. Article
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  11. Achieving Good Glycemic Control Early After Onset of Diabetes: A Cost-Effectiveness Analysis in Patients with Type 1 Diabetes in Sweden.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2018
    Article
  12. Article
  13. Review
  14. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 3 countries.

Aliasghar A KiadaliriHealth Economics Unit, Department of Clinical Sciences-Malmö, Lund University, Medicon Village, SE-223 81, Lund, Sweden, aliasghar.ahmad_kiadaliri@med.lu.se.
Ulf G Gerdtham
Bjorn Eliasson
Katarina Steen Carlsson
Institute of Health Economics · CALund University · SESahlgrenska University Hospital · SETehran University of Medical Sciences · IR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aimed to assess the costs and benefits of three alternative second-line treatment strategies for Swedish patients with type 2 diabetes mellitus (T2DM) who fail to reach glycated hemoglobin (HbA1c) ≤ 7% with metformin treatment alone: glucagon-like peptide-1 (GLP-1) receptor agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and neutral protamine Hagedorn (NPH) insulin.

methodsA previously developed cohort model for T2DM was applied over a 35-year time horizon. Data on T2DM patients on metformin monotherapy with HbA1c > 7% were collected from the Swedish National Diabetes Register. Treatment effects were taken from published studies. Costs and effects were discounted at 3% per annum, and the analysis was conducted from a societal perspective. The robustness of the results was evaluated using one-way and probabilistic sensitivity analyses.

resultsTreatment with GLP-1 agonists was associated with a discounted incremental benefit of 0.10 and 0.25 quality-adjusted life years (QALYs) and higher discounted costs of Swedish Krona (SEK) 34,865 and SEK 40,802 compared with DPP-4 inhibitors and NPH insulin, respectively. Assuming willingness-to-pay (WTP) of SEK 500,000 per QALY, treatment strategy with GLP-1 agonists was a cost-effective option with incremental cost-effectiveness ratios of SEK 353,172 and SEK 160,618 per QALY gained versus DPP-4 inhibitors and NPH insulin, respectively. The results were most sensitive to incidence rate of moderate/major hypoglycemia and disutilities associated with insulin treatment, body mass index (BMI), and hypoglycemia.

conclusionAssuming a WTP of SEK 500,000 per QALY, treatment strategy with GLP-1 agonists is a cost-effective strategy in comparison to DPP-4 inhibitors and NPH insulin among T2DM patients inadequately controlled with metformin alone in a Swedish setting.

Identifiers

PMID25213800
PMCPMC4269657
OpenAlexW1974658403

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.