Resource Utilization and Costs: Comparing Saxagliptin and Sitagliptin

A lower trend seen with saxagliptin, with a few exceptions
August 2013, Vol 6 ADA 2013 Highlights
Mary Mosley

Chicago, IL—The first US-based study to compare healthcare resource utilization and costs during the first 6 months after starting treatment with the dipeptidyl peptidase (DPP)-4 agent saxagliptin (Onglyza) or sitagliptin (Januvia) in patients with type 2 diabetes was reported at the 2013 American Diabetes Association annual meeting by Jasmina I. Ivanova, Vice President, Analysis Group, New York.

Results of the analysis showed lower costs for overall and diabetes-related inpatient care, as well as emergency department visits with saxagliptin. These 2 DPP-4 agents are relatively new to the market.

Patients taking saxagliptin were significantly less likely to have an inpatient hospitalization compared with patients taking sitagliptin, overall (odds ratio [OR], 0.80) or related to diabetes (OR, 0.74; P <.001 for both, risk adjusted).

For this analysis, patients with a primary or secondary diagnosis of type 2 diabetes whose index treatment after 2009 was saxagliptin (N = 13,929) or sitagliptin (N = 36,813) were identified from the Truven MarketScan database of privately insured members.

Approximately 47% of the patients were women, and patients taking saxagliptin were slightly but significantly younger (58 years vs 59 years with sitagliptin). The mean Charlson Comorbidity Index was lower in the patients receiving saxagliptin, but they had higher rates of dyslipidemia (44.8% vs 41.9% with sitagliptin) and hypertension (51.8% vs 49.8% with sitagliptin).

Resource utilization was significantly lower overall with saxagliptin, except for the lower rate of outpatient visits; it was also significantly lower for diabetes-related causes with sax­agliptin, except for outpatient diabetes-related visits.

Although the use of other antidiabetic drugs (as monotherapy or combinations) was higher with saxaglip­tin, the use of sulfonylureas, insulin, and thiazolidinediones was lower.

The patients receiving saxagliptin had higher rates of cardiometabolic risk factors, but they also had less evidence of acute comorbidities than the patients receiving sitagliptin; nevertheless, patients receiving saxagliptin were less likely to be hospitalized.

Healthcare Costs
Healthcare costs were based on third-party payer reimbursements and were adjusted to 2011 US dollars for the first 6 months of treatment with either of the 2 agents. All calculations were based on intention to treat. During the first 6 months of treatment, the costs per patient were:

  • Overall total costs, $7802 with saxagliptin versus $8302 with sitagliptin
  • Overall medical costs, $5073 versus $5535, respectively
  • Diabetes-related medical costs, $1149 versus $1387, respectively
  • Total diabetes-related costs, $2510 versus $2772, respectively.
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