July 31, 2013

The CHOICE Study: Insulin or Byetta for T2D?


CHOICEFor T2D, the drug choices are seemingly infinite. But the cost effectiveness of these drugs needs to be evaluated. A study was published in ClinicoEconomics and Outcomes Research to evaluate the cost-efficacy of insulin versus exenatide.

The CHOICE Study is the changes to treatment outcomes in patients with T2D initiating injectable therapy. The two injectable drugs looked at in this study were insulin and exenatide.  The participants were observed in  clinical practice in 6 European countries and evaluated outcomes during the study.

Over 24 months, participants were followed from their first injectable therapy (exenatide or insulin) and at regular intervals. Costs were evaluated from the national health care system perspective at 2009 prices.

At the 24-month analysis, significant treatment change had occurred during the study in over 42% of patients being treated with exenatide and 36% of patients taking insulin. Improvements in glucose control were observed over the course of the study in both groups but mean weight was reduced in the exenatide group and increased in the insulin group.

Across all countries, total health care costs for the 24 months were due to costs other than those of injectable therapy. The difference between insulin and exenatide costs, per patient, were not significant.  Although the cost of exdenatide is greater than insulin, the additional costs of care with insulin is offset by the savings in further healthcare costs of insulin users.

At the end of the day, this study finds that the use of exenatide or insulin is a draw. The downfall of weight gain is associated with insulin. The downfall of cost is associated with exenatide. However, nobody said staying healthy was cheap. It is invariable that being too heavy can be expensive, especially if you have T2D.

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