OBJECTIVES: To compare the cost-effectiveness of empagliflozin against glimepiride in Type 2 Diabetes Mellitus (T2DM) patients who are uncontrolled with metformin alone.

METHODS: An existing health economic model was used to simulate individual profiles of patients treated with empagliflozin + metformin or glimepiride + metformin followed by a treatment switch to insulin glargine and glimepiride (when HbA1c threshold of 8.5% is reached), over a lifetime horizon. An Argentine healthcare payer perspective was taken including only direct costs. Annual discount rate of 3% was applied to both costs and effects. Model outcomes included annual and cumulative event rates, life years (LY) and quality adjusted life-years (QALYs). A probabilistic sensitivity analysis was conducted to test the robustness of the results.

RESULTS: Empagliflozin resulted in 23.623 LY gained versus 23.011 LY gained by glimepiride with an incremental of 0.612 LYs. The mean QALYs gained by empagliflozin versus glimepiride were 12.602 QALYs and 12.173 QALYs respectively giving a QALY gain of 0.43 at an additional cost of USD 1,777 per patient. These results translated into an ICER of 4,136 USD per QALY gained for empagliflozin compared to glimepiride. Probabilistic sensitivity analyses showed with 99% accuracy that empagliflozin is below the recommended willingness to pay (WTP) threshold of 14,000 USD per QALY.

CONCLUSIONS: Empagliflozin is a cost effective additive treatment for T2DM patients. The cost-effectiveness results was further confirmed with sensitivity analysis.