Pharmacoeconomic analysis of alogliptin use in the treatment of type 2 diabetes

Aim of the study: Determine the validity of alogliptin choice in comparison with other DPP-4 inhibitors, available in Russia (saxagliptin, linagliptin, vildagliptin, sitagliptin) for add-on treatment in patients with inadequate glycemic control on metformin monotherapy, basing on pharmacoeconomic analysis Methodology. Retrospective modeling was performed according to standard pharmacoeconomic methods: cost-minimization analysis, cost-effectiveness analysis (CEA), cost-utility analysis (CUA) and sensitivity analyzes. To predict the long-term impact of the compared therapies on CUA results, a Markov model with 10-year simulation horizon has been used. Results. CEA results showed that lowering HbA1C level by 1% using alogliptin was less expensive than using other agents of the group (sitagliptin, vildagliptin, saxagliptin, linagliptin). The calculated cost per QALY gained for alogliptin therapy was 27 150 rubles, which made the use of alogliptin cost-effective. Conclusions. Alogliptin is a cost-effective alternative in comparison with any other DPP-4 inhibitors (sitagliptin, vildagliptin, saxagliptin, linagliptin) for adding to unsuccessful metformin monotherapy

CLINICAL AND ECONOMICAL COMPARISON OF RIVAROXABAN AND APIXABAN USE IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION

Aim. To compare cost-effectiveness of the use of direct factor Xa inhibitors rivaroxaban and apixaban in patients with non-valvular atrial fibrillation (AF) and to assess the impact of the both therapies on the healthcare budget of Russian Federation.Material and methods. Pharmacoeconomic analysis with "decision tree" modeling is performed. The costs of regimens using rivaroxaban and apixaban were calculated. Assessment of the likelihood of cerebrovascular complications during anticoagulant therapy was performed, and the average additional costs in development of adverse  clinical effects were calculated. The average costs of treatment regimens used in view of the probability of occurrence of all the clinical effects,  were calculated as a result of the modeling.Results. The results of the pharmacoeconomic analysis shown, that the strategy of the use of rivaroxaban for stroke prevention in patients with non-valvular AF is less costly 49558.43 rubles for one patient per year. The strategy of apixaban application costs higher by 0.15% (50027.57 rubles). Cost reduction for the year of rivaroxaban therapy in a cohort  of 1000 patients was 469140 rubles due to decrease in the incidence of cerebrovascular complications in comparison with apixaban therapy.Conclusion. When choosing pharmacotherapy strategy to prevent the stroke in patients with non-valvular AF rivaroxaban use is more effective, than the use of apixaban, from the clinical and pharmacoeconomic points of view