Cost-effectiveness of Canagliflozin versus Sitagliptin When Added to Metformin and Sulfonylurea in Type 2 Diabetes in Canada.

Background Canagliflozin, an agent that inhibits sodium glucose co -transporter 2, is approved as add- on to metformin plus sulfonylurea for the treatment of type 2 diabetes in Canada . Canagliflozin offers greater glycemic control , as well as important additional benefits such as weight loss and blood pressure reductions , versus dipeptidyl peptidase -4 inhibitors such as sitagliptin . Objective This analysis evaluated the cost -effectiveness of canagliflozin 300 mg and canagliflozin 100 mg versus sitagliptin 100 mg in patients with type 2 diabetes inadequately controlled on metformin plus sulfonylurea from the perspective of the Canadian Agency for Drugs and Technologies in Health. Methods A 40- year cost -effectiveness analysis was performed using the validated Economic and Health Outcomes Model of Type 2 Diabetes Mellitus (E CHO- T2DM) . Patient characteristics, treatment effects, and rates of hypoglycemia and adverse events were sourced from the canagliflozin clinical program . Canada -specific costs and utilities were applied . Sensitivity analyses were conducted using alternative values for key model inputs. Results Both c anagliflozin 300 and 100 mg dominated sitagliptin 100 mg over 40 years , providing quality - adjusted life -year gains of 0.31 and 0.28, and cost offsets of $2,217 and $2,5 60, respectively . Both canagliflozin doses dominated sitagliptin in each of the sensitivity analyses. Conclusions Simulation results suggested that c anagliflozin 300 and 100 mg provided better health outcomes and lower costs than sitagliptin 100 mg as a third -line therapy added -on to metformin and sulfonylurea in patients with type 2 diabetes in Canada .