Projecting the incidence and costs of major cardiovascular and kidney complications of type 2 diabetes with widespread SGLT2i and GLP-1 RA use: a cost-effectiveness analysis
Authors' conclusion
At current prices, use of SGLT2is, but not GLP-1 RAs, would be cost-effective when considering only their cardiovascular and kidney disease benefits for people with type 2 diabetes.
Study context
- Population
- People with T2D, with and without CVD, Australian Diabetes Registry linked to hospital admissions, National Death Index and end-stage kidney disease (ESKD) Registry (data 2010–2019); projection 2020–20401.5 million in 2040
- Participants
- 1.1 million people
- Comparison
- Increased SGLT2i or GLP-1 RA use to 75% vs current use
- Outcome
- QALYs gained, net costs and ICER vs current use (total population)
- Follow-up
- 2020 to 2040
Methodological detailsmicrosimulation model, microsimulation model using real-world data, Australian public healthcare perspective, 5% annual discounting, willingness-to-pay threshold AU$28,000 per QALY gained
- Microsimulation model
- Microsimulation model using real-world data
- Australian public healthcare perspective
- 5% annual discounting
- Willingness-to-pay threshold AU$28,000 per QALY gained
Main finding
As reported in the abstract
| Group | Quality-adjusted life years (QALYs) gained | Net cost difference | Incremental cost-effectiveness ratio (ICER) |
|---|---|---|---|
| SGLT2i 75% total | 176,446 | AU$4.2 billion | AU$23,717 per QALY gained |
| GLP-1 RA 75% total | 200,932 | AU$20.2 billion | AU$100,705 per QALY gained |
Quality-adjusted life years (QALYs) gained
SGLT2i 75% total176,446
GLP-1 RA 75% total200,932
Net cost difference
SGLT2i 75% totalAU$4.2 billion
GLP-1 RA 75% totalAU$20.2 billion
Incremental cost-effectiveness ratio (ICER)
SGLT2i 75% totalAU$23,717 per QALY gained
GLP-1 RA 75% totalAU$100,705 per QALY gained
Further findings
ICER in the secondary prevention population (people with T2D and prior CVD) · 2020–2040
AU$
- ICER, SGLT2i use in secondary prevention population
- 8878
- ICER, GLP-1 RA use in secondary prevention population
- 79,742
- vs current use; 5% annual discounting; willingness-to-pay threshold AU$28,000 per QALY gained
Original publication
Projecting the incidence and costs of major cardiovascular and kidney complications of type 2 diabetes with widespread SGLT2i and GLP-1 RA use: a cost-effectiveness analysis. Diabetologia. Published 21 November 2022. doi:10.
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