Cost Effectiveness Evaluation of Canagliflozin in Combination with Metformin and Sulfonylurea in Comparison To Nph Insulin in the Treatment of Type 2 Diabetes Mellitus In Poland.

According to Polish HTA guidelines, a systematic literature review was conducted in which data on comparative efficacy and safety of canagliflozin and NPH insulin were searched. As no head-to-head trial comparing canagliflozin with NPH insulin were identified, mixed treatment comparison analysis was conducted (following Polish HTA guidelines). Two RCTs assessing effectiveness of canagliflozin in triple therapy were identified [2, 3]. Due to lack of trials assessing effectiveness of NPH insulin fulfilling review’s inclusion criteria, it was assumed that the effectiveness of NPH insulin is comparable to effectiveness of insulin glargine [15]. The methodology of calculations for treatment effects focused on relative efficacy measures, therefore we conducted following analysis steps: ■ calculating mean level of HbA1c/BMI/SBP reported at the end of RCTs (follow-up of 26 weeks) for CANA 100 and CANA 300 arm; these outcomes were applied as baseline levels of HbA1c/BMI/SBP in the modeling (Table 1); ■ change of HbA1c/BMI/SBP for CANA 100 and CANA 300 arm was set to zero (as final values reported in trials already including changes of these parameters are used); ■ change of HbA1c/BMI/SBP for NPH was set as the mean difference between interventions obtained from mixed treatment comparison analyses.