Liraglutide: A Cost-Benefit Analysis

The carrying out of cost-benefit analyses of innovative drugs is a complex venture accompanied by various methodological challenges. The German Institute for Quality and Efficiency in Health Care (IQWiG) uses the response rate to indicate benefit, i.e., the number of patients reaching the therapeutic target of any given intervention. We attempted to demonstrate the cost-effectiveness of the GLP-1 analogue, liraglutide, by using data from the LEAD study and applying this to a treatment efficacy parameter for type 2 diabetes mellitus which we had derived from actual treatment guidelines: HbA(1c) <6.5%; no hypoglycaemic events; no weight gain. The LEAD study data was used to calculate an efficacy threshold for liraglutide, glimepiride, rosiglitazone, insulin glargine and exenatide. In addition, a cost-of-control index was determined, indicating the association between the cost-benefit ratios of each drug vs. liraglutide. Liraglutide demonstrated a significantly better cost-benefit profile compared to all the other therapies tested. The addition of further parameters to the efficacy endpoint had no effect on the results. Calculation of the cost-of-control indices, using the same cost-benefit parameters, revealed better results for both dosages of liraglutide vs. rosiglitazone, insulin glargine and exenatide.