Budget impact analysis of ertugliflozin in patients with type 2 diabetes mellitus who failed to achieve glycemic targets on metformin

• Sergey V. Nedogoda
• Alla S. Salasyuk
• Irina N. Barykina
• Victoria О. Lutova
• Ekaterina A. Popova
• Vyacheslav A. Krylov
• Dzhumber T. Ugrekhelidze

Abstract

Aim. Budget impact analysis of the inclusion of ertugliflozin, new inhibitor of sodium-glucose cotransporter-2 (iSGLT-2) into Vital and Essential Drugs List (VEDL). This group of oral hypoglycemic drugs features prominently in the treatment of type 2 diabetes mellitus (T2DM).

Material and methods. In this study an analytical decision-making model in MS Excel was created, which allows to analyze the impact on the budget (BIA) when using ertugliflozin in comparison with other iSGLT-2 drugs for the treatment of T2DM included in the VEDL. The model included only direct medical costs per patient (costs of drug therapy with iSGLT-2). Adult patients with T2DM taking iSGLT-2 to intensify metformin therapy because of its inefficiency in the framework of VEDL were considered as the target population for BIA, according to the IQVIA drug procurement monitoring data for 2020.

Results. BIA showed that with the complete replacement of ertugliflozin in the target population of patients with T2DM can reduce the current burden on the health care system budget by 15% or by 483 million rubles for 1 year of therapy. The average savings of the health care system budget within the VEDL budget for 5 years of therapy will be 10.5% or 316 million rubles. Sensitivity analysis confirmed the stability of the study results to changes in drug prices, the proportion of patients transferred to ertugliflozin during 1-5 years of drug adoption, as well as the size of the target patient population: the difference in the impact on the budget when all of the above parameters fluctuate within ±20% remains in favor of the adoption of ertugliflozin. Changes in the cost of comparison drugs and the number of patients have the greatest effect on the magnitude of the impact on the budget.

Keywords:diabetes mellitus, sodium glucose co-transporter type 2 inhibitors, ertugliflozin, empagliflozin, dapagliflozin, ipragliflozin, budget impact analysis, pharmacoeconomics

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