Evaluating the long‐term cost‐effectiveness of fixed‐ratio combination insulin degludec/liraglutide (IDegLira) for type 2 diabetes in Spain based on real‐world clinical evidence

AIM: To evaluate the long‐term cost‐effectiveness of fixed‐ratio combination insulin degludec/liraglutide (IDegLira) versus comparator regimens for type 2 diabetes in Spain, based on real‐world evidence. MATERIALS AND METHODS: Clinical data were taken from the European Xultophy Treatment Retrospective Audit (EXTRA) real‐world evidence study in which patients failing to meet glycaemic targets were switched to IDegLira. Baseline regimens (prior to IDegLira treatment) were categorized as: multiple daily insulin injections (MDI; 28%); glucagon‐like peptide‐1 (GLP‐1) receptor agonists in combination with insulin (24%); basal insulin (19%); GLP‐1 receptor agonists (10%); and non‐injectable medications (19%). The IQVIA CORE Diabetes Model was used to project long‐term outcomes for patients switching to IDegLira or continuing their baseline regimens (excluding non‐injectable regimens). Costs were accounted from a Spanish National Health System perspective. Future costs and clinical benefits were discounted at 3% annually and sensitivity analyses were performed. RESULTS: IDegLira was projected to reduce the incidence of diabetes‐related complications and improve quality‐adjusted life expectancy versus all four comparators. IDegLira reduced direct medical costs versus GLP‐1 receptor agonists in combination with insulin, and versus GLP‐1 receptor agonist therapy, and was therefore considered dominant (cost saving while improving outcomes). IDegLira was found to be cost‐effective versus MDI and basal insulin with incremental cost‐effectiveness ratios of EUR 3013 per quality‐adjusted life‐year (QALY) gained and EUR 6890 per QALY gained, respectively. CONCLUSIONS: Long‐term projections based on real‐world evidence indicated that IDegLira is likely to improve clinical outcomes and reduce costs or be cost‐effective compared with other injectable regimens in people with type 2 diabetes in Spain.