ADA: Canagliflozin may be cost-effective treatment option for type 2 diabetes with diet, exercise: Studies

In adult patients with type 2 diabetes inadequately controlled on metformin monotherapy-the current standard of treatment- canagliflozin (Invokana) 100 mg and 300 mg reduced relative risk for myocardial infarction (1.6% and 3.0%) and congestive heart failure (2.7% and 4.0%), as compared to sitagliptin 100 mg, according to findings of the health economic simulation analysis presented at the American Diabetes Association (ADA) Scientific Sessions in San Francisco.

The improved outcomes were also associated with lower healthcare costs compared to sitagliptin, and decreased costs by approximately $4,810 and $2,414 for the 300 mg and 100 mg doses, respectively, and improved quality-adjusted life years over a 30-year treatment simulation.

“The findings of this simulation analysis show that the treatment effects of both doses of canagliflozin demonstrated in the head-to-head trial versus sitagliptin could lead to better long-term outcomes and lower costs, both important findings for managed care and hospital decision-makers,” said Silas Martin, analyses coauthor, director of healthcare quality, Janssen Scientific Affairs, LLC

Analyses such as the canagliflozin abstracts presented at the ADA Scientific Sessions help estimate the impact of treatment on clinical outcomes and costs, which is becoming increasingly relevant under the Affordable Care Act, and as the prevalence of diabetes continues to increase, according to Martin.

Latest estimates show that 29 million Americans are affected by diabetes and the cost burden of diagnosed diabetes has risen to $245 billion as of 2012.  

This study is part of a series of analyses modeling the randomized clinical trials of canagliflozin using the validated Economic and Health Outcomes (ECHO) Model. 

Another analysis of data from a randomized clinical trial of canagliflozin versus maximally titrated glimepiride was also presented at ADA.  

“This analysis showed that canagliflozin 100 mg and 300 mg are likely to be cost-effective options versus maximally titrated glimepiride in the United States,” Martin said.

For both analyses, treatment effects, incidence of adverse events, and patient characteristics were sourced from phase 3 trials, DIA3006 and DIA3009 for the sitagliptin and glimepiride comparative analyses, respectively.

“The studies demonstrate the results of mathematical model estimating the long term impact of choosing one therapy over another,” Martin said.

“Based on the simulation analyses presented at ADA, canagliflozin is projected to be a cost-effective treatment option for adults with type 2 diabetes, along with diet and exercise, compared to other commonly-prescribed therapies sitagliptin and glimepiride,” he said.