Cost-effectiveness of iGlarLixi vs. IDegAsp in individuals with type 2 diabetes: a BRAVO model-based evaluation.

BACKGROUND

This study aimed to evaluate the long-term cost-effectiveness of insulin glargine/lixisenatide injection (iGlarLixi) vs. insulin degludec/insulin aspart (IDegAsp) in individuals with poorly controlled type 2 diabetes in China.

METHODS

This study employed the Building, Relating, Assessing, and Validating Outcomes (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 were derived from the Soli-D clinical trial (NCT05413369). Drug prices for iGlarLixi and IDegAsp were sourced from Yaozhi Complication-related costs and utility values were obtained from literature. The primary outcome was the incremental cost-effectiveness ratio. The willingness-to-pay threshold was defined as three times China's per capita gross domestic product ($13,448 in 2024) per Quality Adjusted Life Years (QALY). Both costs and utilities were discounted at 5% annual rate. One-way sensitivity, scenario, and probabilistic sensitivity analyses were conducted to assess the robustness of the findings.

RESULTS

Compared with IDegAsp, iGlarLixi treatment resulted in an additional gain of 0.03 QALYs with a saving of $301.38 (dominant), indicating a favorable economic outcome toward iGlarLixi over IDegAsp. Sensitivity analyses confirmed the robustness of the results. Within the threshold of $40,344/QALY, the probability of iGlarLixi being cost-effective compared with IDegAsp was 83%.

CONCLUSIONS

In individuals with type 2 diabetes inadequately controlled by oral antihyperglycemic agents, treatment with iGlarLixi is associated with superior long-term clinical outcomes and lower healthcare costs compared to IDegAsp in the Chinese healthcare setting.