Cost-effectiveness of intermediate or long-acting insulin versus Exenatide in type 2 diabetes mellitus patients not optimally controlled on dual oral diabetes medications

OBJECTIVE: To better understand exenatide’s role in the treatment of type 2 diabetes, this analysis assessed its cost-effectiveness in comparison to an intermediate (NPH) and long-acting insulin (glargine). Exenatide is a recently approved medication for the treatment of type 2 diabetes for use in addition to frequently used oral diabetes medications. METHODS: Two studies were identified by a Medline search (1996-Oct 2005) that were similar in study duration, baseline glycemic control, population size, and primary outcomes to appropriately assess the cost-effectiveness of either insulin in comparison to exenatide on both glycemic and weight control. RESULTS: Both NPH and glargine appear to be more cost effective than exenatide with respect to glycemic control (incremental CE ratios -1,968 and - 65,520 respectively). Exenatide appears to be more cost effective for reductions in body weight than either NPH (CE ratio 235) or glargine (CE ratio 128). CONCLUSIONS: Compared to intermediate and long-acting insulin therapies, exenatide does not appear to be as cost effective for the treatment of type 2 diabetes.