Li Q, et al. - Researchers performed a comparison of the clinical and economic outcomes of long-term use of liraglutide vs sitagliptin for the treatment of type 2 diabetes (T2DM) in real-world practice in the USA. Observations revealed better glycemic control with long-term use of liraglutide for 1 or 2 years than using sitagliptin. During the 2nd year of persistent treatment, savings in medical costs were realized for liraglutide users which compensate differences in pharmacy costs.

Methods

• Using a large claims database, adult patients (≥ 18 years old) with T2DM who initiated liraglutide or sitagliptin in 2010–2014 were identified.
• Assessment of quarterly glycemic control measures and annual healthcare costs was performed during the 1st and 2nd years of persistent medication use.
• Using multivariable regression models adjusted for patient demographic and clinical characteristics, researchers estimated their associations with medication use (liraglutide or sitagliptin).

Results

• Researchers identified a total of 3,113 patients who persistently used liraglutide (N = 493) or sitagliptin (N = 2620) for ≥ 1 year [mean age (standard deviation, SD): 53 (8.5) vs 56 (9.7) years; 48.3% vs 62.3% males; both p < 0.05]; 911 (including 113 liraglutide users) were persistent users for ≥ 2 years.
• During the 1st-year follow-up, liraglutide users vs sitagliptin users, after adjustment, were noted to experience larger glycated hemoglobin (HbA1c) reductions from baseline (ranging from 0.34%-point in quarter 1 to 0.21%-point in quarter 4); showed higher tendency for obtaining HbA1c reductions of ≥ 1%-points or ≥ 2%-points [odds ratios (ORs) range 1.47–2.04]; and had greater tendency for reaching HbA1c goals of < 6.5% or < 7% (ORs range 1.51–2.12) (all p < 0.05).
• In the 2nd-year follow-up, HbA1c reductions from baseline was also noted in liraglutide users (0.53–0.33%-point, all p < 0.05).
• During the 1st-year follow-up, liraglutide users incurred higher healthcare costs than sitagliptin users, however, in the 2nd year, they had $2674 (per patient) lower all-cause medical costs (adjusted cost ratio: 0.67, p < 0.05) and similar total costs (all-cause and diabetes-related).