Cost effectiveness of dapagliflozin/metformin versus glibenclamide/metformin for the treatment of type 2 diabetes in chile

To assess the cost-effectiveness of dapagliflozin in combination with metformin versus glibenclamide in combination with metformin for the treatment of patients with type 2 diabetes, from the perspective of the Chilean public healthcare system A discrete event simulation model was built to estimate the lifetime expected costs and health benefits measured as quality adjusted life years (QALYs). Individual patient risk profile based on the Chile 2010 national health survey were used. Time to event for disease complications and death was estimated using the published equations from the UKPDS Outcomes Model 2 study. Efficacy was obtained from a network meta-analyses and costs were estimated from local sources. Utilities were obtained from the literature. A time horizon of 50 years and a 3% discount rate was considered for costs and outcomes. Probabilistic sensitivity analyses was performed The ICER of dapagliflozin/metformin compared to glibenclamide/metformin was US$ 20.811/QALY at a price of US$38 per month (pm); US$13.887/QALY at a price of US$29 pm and US$6.963/QALY at a price of US$19 pm. The probability of cost effectiveness of dapagliflozin/metformin at a pm price of US$38 was 42% and increases to 95% when the pm price is reduced to US$19 dapagliflozin/metformin can be considered cost-effective at a particular price range. These results provide decision makers useful information about the value of incorporating these drugs into the public Chilean healthcare system