This is the title of my latest paper JMCP With co-author Jehong Kim, Shakshan Wang, Moise Marin, Slavan Sikirika and Maryam Anderson. The study essence is below.
background:
Patients with type 1 diabetes (T1D) have more than 50% of a lifetime risk of developing comorid chronic kidney disease (CKD). Glycemic control can reduce complications and slow CKD progression related to diabetes. In insulin therapy compared to insulin monotherapy in T1D patients, adding Sotagliflose to insulin therapy decreased by 0.46%. However, long -term economic values are unknown for patients with both T1D and CKD.
Objective:
To evaluate the cost-efficiency of sotagliflozin as an ad-on for insulin in patients from an American payment perspective with T1D and CKD.
Methods:
A markov model was generated for individuals diagnosed with both T1D and Comorbid CKD Stage 3 from the US pair point of view. Clinical and economic results were evaluated in 30 years and included dialysis and transplantation, life-year, quality-appointed life-year (QALY) benefits, incremental costs, incremental cost-efficiency ratio (ICER), and a number of patients prevented by pure monetary benefits. Dynamic pricing through genericization was included for the economic effects of the entry into the market by the generic.
Result:
Sotagliflozin add-on therapy improved existence, expanding life expectancy up to 1.27 years (13.08 sotagliflozin vs. 11.81 with insulin monotherapy). During the first 10 years after initiation of treatment, dialysis and transplant use decreased by 1,000 patients per 1,000 (99.35 vs. 102.41) and 1.73 (30.59 vs. 32.32) respectively. Qallys 0.63 (7.70 vs. 7.07) per patient increased, largely operated in the health states (0.59; 6.75 vs. 6.16) of pre-phase of renal disease. The total cost increased by $ 72,914 ($ 484,674 vs $ 411,760), mainly the cost of the pharmacy is growing from $ 69,060 ($ 96,242 vs. $ 27,364). The ICER was $ 115,677 per QALY and the model was the most sensitive to the pharmacy cost.
conclusion:
Sotagliflozin T1D and CKD are a cost-effective accessory for insulin therapy for patients, which provides clinical benefits and falls into 59% possible sensitivity analysis simulation from $ 150,000/QALY desire-to-rentive threshold.
You can read full paper Here,
