Becker F, Dakin HA, Reed SD, et al. - Once-weekly exenatide (EQW) added to usual care for treating type 2 diabetes led to increased quality-adjusted life-years (QALYs) and costs than usual care alone, in a lifetime extrapolation. The base-case incremental cost-effectiveness ratios (ICERs) were greater than the commonly-cited cost-effectiveness thresholds of $100,000/QALY and £20,000/QALY. However, considerably lower ICERs were noted in some subgroups, and in sensitivity analyses.

• In the EXSCEL (Exenatide Study of Cardiovascular Event Lowering) trial, EQW vs placebo, added to usual care, was evaluated in 14,752 patients with type 2 diabetes mellitus.

• In this analysis, the lifetime cost-effectiveness of adding EQW compared with usual care alone was evaluated from a healthcare perspective.

• In a US setting, 0.162 QALYs were gained with EQW plus usual care at an additional cost of $41,545/patient, vs usual care.

• The ICER was estimated to be $259,223/QALY.

• In a UK setting, 0.151 QALYs were gained at an additional cost of £6357, providing an ICER of £42,589/QALY.

• Sensitivity analyses ranged between $34,369-$269,571 and £3,430-£46,560 per QALY gained.