Pharmacoeconomic characteristics of agonists of receptors for glucagon-like peptide-1 and medicines on their base

The effective control of Diabetes Mellitus (DM) is an actual problem from optimal expenditures of health care system point of view. Agonists of receptors for glucagon like peptide-1 (aGLP-1) are one of the modern option for glycemia control in DM Type 2 and included in all current guidelines for the treatment control. The economic comparative aspects of the use of these drugs in the local conditions have not been studied. Materials and methods. Comparative economic evaluation of insulin glargine + lixisenatide (iGlaLixi), exenatide (Exe), dulaglutide (Dula), liraglutide (Lira) and combinations of their aGLP-1 with iGla 100 U has been performed base on published clinical data of efficacy. Number of patients with HbA1c <7 % was chosen as efficacy criterion. Non-direct comparison with Odds Ratio (OR) calculation was prepared. Direct and indirect costs (medications, treatment of CV-complications, GDP loses etc.) were indicated and calculated based on constructed model. Sensitivity analysis has been provided for validation of results. Results. Pharmacoeconomic analysis based on non-direct efficacy comparisons of iGlaLixi, Exe, Lira and Dula has shown of economic advantages of effective DM2T control. iGlaLixi has demonstrated economic advantages as well usage aGLP-1 only (direct costs decreasing vs Exe on 23,8 %, vs Dula on 15,6 %, vs Lira on 54,4 %) as their combinations with iGla 100 U (direct costs decreasing vs iGla 100 U + Exe on 23,8 %, vs iGla 100 U + Dula on 15,2 %). iGlaLixi decreased a total cost (direct and non-direct) better than Exe, Dula and Lira (on 19,9, 9,3 и 45,2 % accordingly). Conclusion. An effective control of DM2T with aGLP-1 and medicines on their base has an economic value because lead to expenditures for complications decreasing from government position.

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Pharmacoeconomic comparison of the second generation insulin analogs and insulins on their base

Kachestvennaya klinicheskaya praktika ◽

10.37489/2588-0519-2021-1-4-15 ◽

2021 ◽

Vol 20 (1) ◽

pp. 4-15

Author(s):

I. N. Dyakov ◽

S. K. Zyryanov

Keyword(s):

Second Generation ◽

Indirect Costs ◽

Insulin Degludec ◽

Effective Control ◽

Medication Cost ◽

Insulin Analogs ◽

Number Of Patients ◽

Control Of Diabetes ◽

Dm Type 2

Effective control of Diabetes Mellitus (DM) is an actual task from clinical and economic points of view. The second generation insulin analogs increase level of DM compensation without hypoglycemia. The economic aspects of their usage have been evaluated early, but it is still actual due to changes in prices and new data about clinical efficacy were published.Materials and methods: Clinical-economic comparison of insulin glargine 300 U/ml (iGla 300), insulin degludec (iDeg) and insulin degludec/ insulin aspart (iDegAsp) in the Russian conditions has been performed in naïve patients’ group as well as in the group of patients with previous insulintherapy. Number of patients with HbA1c <7 % was chosen as efficacy criterion. Direct and indirect costs (medications, treatment of CV-complications, GDP loses etc.) were indicated and calculated based on the constructed model.Results: iGla 300 can give an economy till 20 % for medication cost and till 10 % for direct medical expenditures in compare with iDeg in DM Type 1. For both patients’ groups iGla 300 can save 10-23 % of sources in compare with iGed and iDegAsp in DM Type 2. In DM2T iGla 300 had more efficacy and less cost in compare with iDeg in elderly patients with renal insufficiency.Conclusion: An effective control of DM with modern insulins is profitable from government position of payment due to decreasing expenditures for complications treatment.

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How Can We Help Alleviate the Financial Concerns of Non-Directed (Altruistic) Living Kidney Donors?

Progress in Transplantation ◽

10.1177/1526924820978589 ◽

2020 ◽

pp. 152692482097858

Author(s):

Ariella Maghen ◽

Georgina Mendoza ◽

Grecia B. Vargas ◽

Sarah E. Connor ◽

Sima Nassiri ◽

...

Keyword(s):

Financial Support ◽

Financial Stability ◽

Negative Impact ◽

Financial Burden ◽

Indirect Costs ◽

The United States ◽

Direct Costs ◽

Full Potential ◽

Donor Pool ◽

Number Of Patients

Introduction: The recent increase in non-directed donors (NDDs) in the United States (U.S.) may help reduce the overwhelming number of patients on the waitlist. However, non-directed donation may be limiting its full potential. Out-of-pocket donation costs upward of $8,000 may be a barrier to potential donors with altruistic tendencies, but inadequate financial support. This study aimed to describe the financial concerns of 31 U.S. NDDs. Methods: We conducted qualitative interviews and administered quantitative demographic surveys between April 2013 and April 2015. Interview transcripts were analyzed using grounded theory techniques to describe and expand on themes relevant to the NDD experience. Findings: We identified 4 sub-themes related to the theme of financial concerns: (1) direct costs related to transportation, lodging, and parking, (2) indirect costs of lost wages encountered from taking time off work to recover from surgery, (3) sources of financial support, and (4) suggestions for alleviating donor financial burden. Two thirds of participants (20) expressed concerns about direct and indirect donation costs. 11 NDDs reported the negative impact of direct costs,15 NDDs had concerns about indirect costs; only 7 donors received supplemental financial support from state mandates and transplant programs. Discussion: Understanding the financial concerns of NDDs may guide improvements in the NDD donation experience that could support individuals who are interested in donating but lack the financial stability to donate. Removing financial disincentives may help increase nondirected donation rates, increase the living donor pool, and the number of kidneys available for transplantation.

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The time-varying cardiovascular benefits of glucagon like peptide-1 agonist (GLP-RA)therapy in patients with type 2 diabetes mellitus: A meta-analysis of multinational randomized trials

10.37766/inplasy2021.7.0097 ◽

2021 ◽

Author(s):

Salil Deo ◽

◽

David McAllister ◽

Naveed Sattar ◽

Jill Pell

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Receptor Agonist ◽

Meta Analysis ◽

Agonist Therapy ◽

Number Of Patients ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

Review question / Objective: P - patients with type 2 diabetes melllitus already receiving routine medical therapy; I - patients receiving glucagon like peptide 1 receptor agonist (GLP1 receptor agonist) therapy (semaglutide, dulaglutide, liraglutide, exenatide, lixisenatide, efpeglenatide, abiglutide); C - patients receiving standard therapy for diabetes mellitus but not receiving GLP1 agonist therapy; O - composite end point as per invididual trial, cardiovascular mortality, all-cause mortality, myocardial infarction, stoke. Condition being studied: Type 2 diabetes mellitus. Study designs to be included: Randomised controlled trials which enroll a large number of patients (defined as > 500) and are multinational in origin. Studies included will need to have published Kaplan and Meier curves for the end-points presented in the manuscript.

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Pharmacoeconomic analysis of using of tiotropium bromide (Spiriva® Respimat®) as adjunctive therapy in patients with asthma in the Russian Federation

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja439 ◽

2015 ◽

Vol 12 (5) ◽

pp. 49-58

Author(s):

A S Kolbin ◽

T L Galankin ◽

M A Proskurin ◽

Y E Balykina

Keyword(s):

Adjunctive Therapy ◽

Standard Therapy ◽

Impact Analysis ◽

Budget Impact ◽

Pharmacoeconomic Analysis ◽

Indirect Costs ◽

Budget Impact Analysis ◽

Tiotropium Bromide ◽

Severe Exacerbation ◽

Number Of Patients

For the first time in Russian economic conditions clinical and economic evaluation of the appropriateness of tiotropium bromide as adjunctive therapy (in addition to the standard therapy) was carried out in patients with severe asthma. Markov model was built using direct and indirect costs, data efficiency and effectiveness; research horizon was 1 year. An additional model was comparing tiotropium bromide (plus standard therapy) and omalizumab (plus standard therapy) with standard therapy. Sensitivity analysis and the budget impact analysis were done. The modeling showed that the use of the strategy of «tiotropium plus standard therapy» increased the likelihood of patients to remain in a state of controlled asthma compared to other strategies. The strategy «tiotropium plus standard therapy» reduced the likelihood of a severe exacerbation compared with standard therapy. Thus, taking into account high frequency of hospitalization of patients with asthma in Russia that was shown in pharmacoepidemiological studies, the use of tiotropium is absolutely appropriate medical technology from the standpoint of clinical and economic analysis. The strategy of using tiotropium is the most preferred strategy in terms of the budget impact analysis when compared with the strategy of omalizumab: the use of tiotropium strategy allows to save substantial budget funds that can be further used to treat a considerable number of patients.

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Diabetes and obesity. The role of agonists glucagon-like peptide-1 of in the treatment of type 2 diabetes

Diabetes Mellitus ◽

10.14341/dm9623 ◽

2018 ◽

Vol 21 (4) ◽

pp. 293-300 ◽

Cited By ~ 1

Author(s):

Nina A. Petunina ◽

Milena Е. Telnova

Keyword(s):

Type 2 Diabetes ◽

Insulin Response ◽

Diabetic Patients ◽

Incretin Effect ◽

Receptor Agonists ◽

Number Of Patients ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1 ◽

Diabetes And Obesity

Significant number of patients with type 2 diabetes mellitus are obese. It is known that even glucose intolerance, as well as diabetes, can lead to vascular complications. At the same time, weight loss can reduce the risk of type 2 diabetes in obese and pre-diabetic patients. According to available data, a significant decrease in the incretin effect is observed in patients with type 2 diabetes and obese individuals. Thus, a decrease in the incretin effect leads to a violation of the insulin response to the intake of carbohydrates, and, consequently, an increase in the level of glucose in the blood. It was also found that the decrease in the incretin effect in patients with type 2 diabetes can be associated with a lower secretion of glucagon-like peptide-1. The interest is represented by groups of antidiabetic drugs capable of regulating glycemia by affecting the secretion of insulin and glucagon, depending on its level. Such drugs include glucagon-like peptide-1 receptor agonists. The article shows the advantage of prolonged action in patients with type 2 diabetes and obesity of the glucagon-like peptide 1 receptor agonists (albiglutide, dulaglutide, exenatide with slow release) dosing 1 time a week.

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