Evaluation of the long-term cost-effectiveness of liraglutide vs lixisenatide for treatment of type 2 diabetes mellitus in the UK setting.

AIMS: To compare the cost-effectiveness of 2 glucagon-like peptide-1 (GLP-1) receptor agonists, liraglutide 1.8 mg and lixisenatide 20 µg, in the UK setting based on the LIRA-LIXI trial (NCT01973231). MATERIALS AND METHODS: Projections of costs (in 2015 pounds sterling [£]) and clinical outcomes were made over patient lifetimes using the IMS CORE Diabetes Model (IMS Health, Basel, Switzerland). The baseline cohort and treatment effects applied after initiation of GLP-1 receptor agonists were taken from the LIRA-LIXI trial. Future costs and clinical benefits were discounted at 3.5% annually. RESULTS: Liraglutide 1.8 mg was associated with improved discounted quality-adjusted life expectancy (8.87 vs 8.76 quality-adjusted life years [QALYs]) vs lixisenatide 20 µg. A greater reduction in glycated haemoglobin with liraglutide 1.8 mg led to fewer diabetes-related complications and delayed their time of onset. Liraglutide 1.8 mg was associated with increased total costs (£37 153 vs £36 174), driven by higher acquisition costs, but this was partially offset by savings from diabetes-related complications avoided (£26 969 vs £27 912). Liraglutide 1.8 mg was associated with an incremental cost-effectiveness ratio of £8901 per QALY gained vs lixisenatide 20 µg. CONCLUSIONS: Long-term projections suggest that treatment of patients with type 2 diabetes with liraglutide 1.8 mg is likely to be considered highly cost-effective compared with lixisenatide 20 µg treatment in the UK setting.