Evidence mapPaperPMID 33236481Full record

ArticleDiabetes, obesity & metabolism2021

Cost-effectiveness analysis of empagliflozin versus sitagliptin as second-line therapy for treatment in patients with type 2 diabetes in the United States.

Odette Reifsnider, Anuraag Kansal, Pratik Pimple, Valerie Aponte-Ribero, Sarah Brand, Sharash Shetty

Open access · hybridAbstract read
In one paragraph

Article in Diabetes, obesity & metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
2.4field-weighted citation impact, top 10% 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

18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 24 citations in OpenAlex.

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  15. Performance of the UK Prospective Diabetes Study Outcomes Model 2 in a Contemporary UK Type 2 Diabetes Trial Cohort.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2022
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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

6 authors at 3 institutions in 2 countries.

Odette ReifsniderEvidera, Bethesda, Maryland, USA.ORCID 0000-0003-0714-5619
Anuraag KansalEvidera, Bethesda, Maryland, USA.
Pratik PimpleBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut, USA.
Valerie Aponte-RiberoEvidera, The Ark, London, UK.
Sarah BrandEvidera, Bethesda, Maryland, USA.ORCID 0000-0003-3116-5951
Sharash ShettyBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut, USA.
Ithaka Harbors · USBoehringer Ingelheim (United States) · USThe Ark · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo estimate the cost-effectiveness of sequential addition of empagliflozin versus sitagliptin after metformin in patients with type 2 diabetes (T2D) with or without cardiovascular disease (CVD) from the perspective of the US healthcare payer.

methodsAn individual simulation model predicted lifetime diabetes-related complications, using UKPDS-OM2 equations in patients without CVD, and EMPA-REG OUTCOME equations in patients with CVD. Additional US-based sources informed inputs for population characteristics, adverse events, non-CV death, treatment escalation, quality of life and costs. Costs and quality-adjusted life-years (QALYs) were discounted 3.0% annually.

resultsThe incremental cost-effectiveness ratio (ICER) for second-line empagliflozin versus sitagliptin in the overall T2D population was $6967/QALY. Empagliflozin led to longer CVD-free survival (0.07 years) and an 11% reduction in CV death in patients with CVD compared with sitagliptin. Empagliflozin resulted in greater benefits with greater costs in patients with versus without baseline CVD, yielding ICERs of $3589/QALY versus $12 577/QALY, respectively. Results were consistent across a range of deterministic and probabilistic sensitivity analyses and scenarios.

conclusionCompared with sitagliptin, empagliflozin was cost-effective (at $50 000/QALY US threshold) as a second-line treatment to metformin for T2D patients with or without CVD in the United States. Our findings lend additional support for more widespread adoption of guidelines by healthcare decision-makers for T2D treatment.

Indexed as

Diabetes Mellitus, Type 2Benzhydryl CompoundsCost-Benefit AnalysisGlucosidesHumansHypoglycemic AgentsQuality-Adjusted Life YearsQuality of LifeSitagliptin PhosphateUnited StatesBenzhydryl CompoundsempagliflozinGlucosidesHypoglycemic AgentsSitagliptin Phosphatecardiovascular disease, cost-effectiveness, empagliflozin, sitagliptin, sodium-glucose co-transporter-2 inhibitor, type 2 diabetes, United States

Identifiers

PMID33236481
PMCPMC7898389
OpenAlexW3110290578

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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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.