iGlarLixi proves cost-effective and clinically superior to IDegAsp for type 2 diabetes in China

Managing type 2 diabetes (T2D) effectively and affordably remains a significant global health challenge, particularly in populous nations like China. Achieving long-term glycemic control while minimizing complications is paramount, yet current standard-of-care often falls short or incurs high costs. Fixed-ratio combinations of basal insulin and GLP-1 receptor agonists, such as iGlarLixi and IDegAsp, offer simplified regimens but require robust economic evaluation. This study addresses the critical gap in understanding the comparative cost-effectiveness of these specific therapies within the Chinese healthcare system.

This study employed the BRAVO diabetes model to simulate 20-year clinical and economic outcomes from the perspective of the Chinese healthcare system. Baseline cohort characteristics and treatment effects for iGlarLixi (insulin glargine/lixisenatide) and IDegAsp (insulin degludec/insulin aspart) were derived from the Soli-D clinical trial (NCT05413369). Drug prices were sourced from Yaozhi, while complication-related costs and utility values were obtained from literature. The primary outcome was the incremental cost-effectiveness ratio, with a willingness-to-pay (WTP) threshold set at $40,344/QALY (three times China's per capita GDP). Both costs and utilities were discounted at a 5% annual rate, and robustness was assessed via one-way, scenario, and probabilistic sensitivity analyses.

iGlarLixi treatment demonstrated superior economic and clinical outcomes compared to IDegAsp over a 20-year simulation period. This favorable economic outcome for iGlarLixi was consistent across various analyses, indicating a dominant strategy. Within the defined willingness-to-pay threshold of $40,344/QALY, iGlarLixi had a high probability of being cost-effective, specifically 83% compared to IDegAsp. Sensitivity analyses further confirmed the robustness of these findings, indicating that the results were stable under varying assumptions of key parameters. This suggests that the combination of insulin glargine and lixisenatide offers a significant advantage in terms of both health benefits and economic efficiency in the long term. > Compared with IDegAsp, iGlarLixi treatment resulted in an additional gain of 0.03 Quality-Adjusted Life Years (QALYs) with a saving of $301.38 per patient, making it the dominant strategy.