Cost-effectiveness of GLP-1 receptor agonists versus insulin for the treatment of type 2 diabetes: a real-world study and systematic review

Table 1 Disaggregated results of effectiveness associated with GLP-1RAs versus insulin therapy for clinical outcomes for a cost-effectiveness analysis

Outcome	Incidence rate per 1000 person-years		Mean follow-up time in years (overall)	HR and 95% CI^c	NNT^d
Outcome	GLP-1RAs	Insulin	Mean follow-up time in years (overall)	HR and 95% CI^c	NNT^d
Composite CVD^a	50.94	55.05	2.15	1.19 (0.91, 1.57)	N/A
MACE^b	13.73	17.89	2.26	1.13 (0.68, 1.89)	N/A
Fatal CVD	2.53	3.83	2.31	1.66 (0.50, 5.51)	N/A
All-cause death	3.81	13.88	2.28	0.40 (0.18, 0.91)^*	56.63
Hospitalized hypoglycemia	10.73	25.75	2.26	0.43 (0.27, 0.69)^**	30.06

GLP-1RAs: glucagon-like peptide-1 receptor agonists; HR: hazard ratio; CI: confidence interval; NNT: number needed to treat; CVD: cardiovascular disease; N/A: not applicable; MACE: major adverse cardiovascular events
^aComposite CVD included acute myocardial infarction, ischemic heart disease, heart failure, stroke, cardiogenic shock, sudden cardiac arrest, arteriosclerotic cardiovascular disease, and arrhythmia
^bMACE denotes three-point major adverse cardiovascular events, including non-fatal myocardial infarction, non-fatal stroke, and fatal CVD
^cThe Cox model analysis was undertaken with a robust sandwich covariance matrix estimator to account for the re-use of stable use sets of insulin in the matching for GLP-1RA users
^dThe NNT estimate was only estimated for study outcomes with a statistically significant difference between two treatment groups (i.e., p-value of hazard ratio < 0.05). The NNT was constructed based on the calculation of survival probabilities from the Cox proportional model with the adjustment of imbalanced baseline patient characteristics shown in Additional file 1: Table S2
* p < 0.05, ** p < 0.001

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