Cost-effectiveness of iGlarLixi vs. IDegAsp in individuals with type 2 diabetes: a BRAVO model-based evaluation.

BACKGROUND: This study aimed to evaluate the long-term cost-effectiveness of insulin glargine/lixisenatide injection (iGlarLixi) vs. insulin degludec/insulin aspart (IDegAsp) in individuals with poorly controlled type 2 diabetes in China. METHODS: This study employed the Building, Relating, Assessing, and Validating Outcomes (BRAVO) diabetes model to simulate 20-year clinical and economic outcomes from the perspective of the Chinese healthcare system. Baseline cohort characteristics and treatment effects were derived from the Soli-D clinical trial (NCT05413369). Drug prices for iGlarLixi and IDegAsp were sourced from Yaozhi Complication-related costs and utility values were obtained from literature. The primary outcome was the incremental cost-effectiveness ratio. The willingness-to-pay threshold was defined as three times China's per capita gross domestic product ($13,448 in 2024) per Quality Adjusted Life Years (QALY). Both costs and utilities were discounted at 5% annual rate. One-way sensitivity, scenario, and probabilistic sensitivity analyses were conducted to assess the robustness of the findings. RESULTS: Compared with IDegAsp, iGlarLixi treatment resulted in an additional gain of 0.03 QALYs with a saving of $301.38 (dominant), indicating a favorable economic outcome toward iGlarLixi over IDegAsp. Sensitivity analyses confirmed the robustness of the results. Within the threshold of $40,344/QALY, the probability of iGlarLixi being cost-effective compared with IDegAsp was 83%. CONCLUSIONS: In individuals with type 2 diabetes inadequately controlled by oral antihyperglycemic agents, treatment with iGlarLixi is associated with superior long-term clinical outcomes and lower healthcare costs compared to IDegAsp in the Chinese healthcare setting.