Project example 11: Diabetes

Project type	Cost-utility analysis
Indication	Diabetes type 2
Intervention	Supplemental oral medication
Methods	Disease elimination life table analysis (DELTA) model
Countries	United Kingdom The Netherlands
Deliverables	Report Journal article
Presentations	Internation Society for Pharmacoeconomics and Outcomes Research (ISPOR) conference. Dublin 2007. Poster presentation.
Publications	Cost-effectiveness analysis of Sitagliptin when added to ongoing Metformin in patient with type 2 diabetes in the Netherlands: Application of a Disease Elimination Life Table Analysis (DELTA) model. Verheggen BG et al. In preparation.

The aim of this project was to assess the cost-utility of adding Sitagliptin to concurrent Metformin, compared to adding Rosiglitazone to concurrent Metformin in diabetic patients without adequate glycemic control despite Metformin treatment, diet and exercise. We have developed a Disease Elimination Life Table Anlysis (DELTA) model containing five sub-models representing diabetes related complications. Estimates of disease progression, indcidence of complications, disease related mortality, and all cause mortality were derived from the United KIngdom Prospective Diabetes Study (UKPDS). Estimates regarding drug efficacy and adverse events were based on an 18-week head-to-head comparison of Sitagliptin versus Rosiglitazone added to Metformin. To determine the robustness of the model and the impact of uncertainty, both univariate and multivariate sensitivity analyses were performed. The methods and results were documented to the sponsor in an internal report. An article for publication is currently in preparation.