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Long-term costs and clinical outcomes associated with metformin-glibenclamide combination tablets (Glucovance®) in patients with type 2 diabetes sub-optimally controlled by metformin: a modelling study in the French setting

CORE, Center for Outcomes Research, A Unit of IMS Health, Gewerbestrasse 25, 4123 Allschwil, Switzerland

Dominique Huet

Hopital St Michel, 33 rue Olivier De Serres, Paris 75015, France

William J Valentine

CORE, Center for Outcomes Research, A Unit of IMS Health, Gewerbestrasse 25, 4123 Allschwil, Switzerland

Andrew J Palmer

CORE, Center for Outcomes Research, A Unit of IMS Health, Gewerbestrasse 25, 4123 Allschwil, Switzerland

Nathalie Cugnardey

Medical and Regulatory Department, Merck Lipha Santé, part of Merck Serono, 37 rue Saint-Romain, 69008 Lyon, France

Corinne Renaudin

Pricing and Health Economics - Global Marketing, Merck Santé, part of Merck Serono, 37 rue Saint-Romain, 69008 Lyon, France, corinne.renaudin{at}merck.fr

Objectives

Most patients eventually become hyperglycaemic on metformin monotherapy. We modelled clinical and economic consequences for such patients of switching to a single-tablet metformin-glibenclamide combination (Glucovance®) or glibenclamide, or increasing metformin dosage.

Methods

A validated computer simulation model of diabetes projected long-term clinical and cost outcomes for the French setting, using data from a 16-week randomised controlled trial.

Results

Compared with metformin, Glucovance® 500/2.5 mg or 500/5 mg was associated with increased quality-adjusted life expectancy (0.45 and 0.27 quality-adjusted life-years [QALYs] respectively; base case analysis), reduced direct medical costs (by 3,331 and 2,026) and fewer diabetes-related complications. Compared with glibenclamide, Glucovance® 500/5 mg increased quality-adjusted life expectancy by 0.28 QALYs and reduced direct medical costs by 1,793.

Conclusions

From a third-party healthcare payer perspective in France, Glucovance® represents a dominant treatment option versus metformin or glibenclamide for patients sub-optimally controlled on metformin monotherapy.

Key Words: cost-effectiveness • glibenclamide • Glucovance® • metformin • oral antidiabetic combination therapy • type 2 diabetes.

The British Journal of Diabetes & Vascular Disease, Vol. 8, No. 1, 39-44 (2008)
DOI: 10.1177/14746514080080010901


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