Liraglutide vs. Sitagliptin: Comparing Clinical and Cost Outcomes in the Real-World

the MPR take:

The prevalence and high costs associated with treating type 2 diabetes in the U.S. was the basis for a new study published in the journal Diabetes Therapy. Researchers aimed to compare the real-world effectiveness and associated economic outcomes of two diabetes therapies: liraglutide, an injectable glucagon-like peptide-1 (GLP-1) receptor agonist and sitagliptin, an oral dipeptidyl peptidase-4 (DPP-4) inhibitor. The study used a large U.S. claims database to identify type 2 diabetes patients who had started therapy with either liraglutide or sitagliptin between January 2010 and December 2010. The primary efficacy outcomes were changes in A1C and the proportion of patients reaching A1C targets at 6-month follow-up; associated costs (medical and pharmacy costs) were also assessed during the follow-up period. Based on analysis of the study population (1,465 patients: liraglutide=376; sitagliptin=1,089), and controlling for other factors, patients in the liraglutide group experienced 0.31% points greater reduction in A1C than patients in the sitagliptin group (0.95% vs. 0.63% points; p<0.01); they were also more likely to achieve A1C targets of ≤6.5% and <7%. For the liraglutide group, diabetes-related medical costs were lower than the sitagliptin group ($1,241 vs. $2,235; p<0.01); however, pharmacy costs were higher for the liraglutide group ($2,100 vs. $1,556; p<0.01). Researchers concluded that while the pharmacy costs were higher for patients using liraglutide, the increased cost was offset by the lower medical costs, resulting in similar overall costs for both therapies. As for effectiveness, liraglutide showed greater improvement in glycemic control.

The objective of this study was to compare the clinical effectiveness of liraglutide with sitagliptin and assess the associated economic outcomes in patients with type 2 diabetes mellitus (T2DM) treated in real-world practice in the United States (US).