Table 4. Sensitivity analyses for liraglutide 1.8 mg compared with lixisenatide 20 μg (each added to basal insulin).
| Base-case scenario | ΔCosts (SEK) | ΔQALYs | Cost/QALY (SEK)a |
|---|---|---|---|
| Liraglutide 1.8 mg versus lixisenatide (each added to insulin glargine) | 26,414 | 0.86 | 30,802 |
| Alternative time horizons | |||
| 30 years | 25,829 | 0.85 | 30,521 |
| 20 years | 39,231 | 0.77 | 50,964 |
| 10 years | 46,487 | 0.48 | 97,075 |
| Alternative discount rates | |||
| 0% | 13,210 | 1.21 | 10,901 |
| 5% | 30,329 | 0.69 | 43,769 |
| Different assumptions for HbA1c | |||
| Treatment intensification at HbA1c 8.2% instead of 8.8% | 13,396 | 0.93 | 14,357 |
| HbA1c progression for GLP-1 = 0.08% | 44,566 | 0.88 | 50,459 |
| Key outcome drivers abolished or changed | |||
| Between-treatment difference in HbA1c abolished | 76,326 | 0.09 | 817,877 |
| HbA1c difference between treatments, 95% CI lower bound | 43,368 | 0.63 | 68,528 |
| HbA1c difference between treatments, 95% CI upper bound | 4,637 | 1.06 | 4,637 |
| Between-treatment difference in BMI abolished | 26,511 | 0.81 | 32,668 |
| BMI difference between treatments, 95% CI lower bound | 26,470 | 0.83 | 32,017 |
| BMI difference between treatments, 95% CI upper bound | 26,360 | 0.91 | 29,017 |
| Alternative treatment costs | |||
| Healthcare perspective | 28,028 | 0.86 | 32,591 |
| Liraglutide 1.8 mg replaced with 1.2 mgb | –13,996 | 0.58 | Liraglutide dominant |
| Insulin glargine replaced with an intermediate-acting basal insulin (Insuman® basal) | 22,540 | 0.86 | 26,285 |
| Alternative complication costs | |||
| +20% | 17,790 | 0.86 | 20,746 |
| −20% | 35,080 | 0.86 | 40,908 |
| Alternative assumptions about patient utility | |||
| No patient utility from treatment (flexibility, injections procedures and SMBG) and short-term HbA1c utility | 26,414 | 0.32 | 81,601 |
aAs the cost/QALY is calculated directly from individual values in the model, the results are not necessarily identical to those seen when dividing mean Δcosts by mean ΔQALY values.
bRelative efficacy derived from LEAD 3. Prices for drugs were obtained from the Swedish Dental and Pharmaceutical Benefits Agency price database in July 2016. All other costs are reported in 2015 values. Δ, difference in; BMI, body mass index; HbA1c, glycated haemoglobin; QALY, quality-adjusted life-year; SMBG, self-monitoring of blood glucose.