Economic evaluation of liraglutide versus sitagliptin in the treatment of type 2 diabetes mellitus inadequately controlled with metformin.

Authors

Fengkun Yang, Xiaohui Zheng, Wenqi Li, Zhenying Zhao

Published in

Frontiers in clinical diabetes and healthcare. Volume 7. Pages 1906364. Epub Aug 07, 2026.

Abstract

To assess the long-term economic value of liraglutide compared with sitagliptin among patients with type 2 diabetes mellitus (T2DM) who fail to achieve adequate glycemic control with metformin monotherapy.
A Markov model based on China's health system was constructed. Using data from the 1860-LIRA-DPP-4 study, long-term costs, and utilities over a 30-year horizon were simulated for Chinese T2DM patients receiving liraglutide or sitagliptin in combination with metformin. The incremental cost-effectiveness ratio (ICER) was estimated against a willingness-to-pay (WTP) threshold of three times the 2025 per capita gross domestic product (GDP) in China. One-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analysis were performed to validate the robustness of the base-case results.
Thirty-year disease simulation showed that, compared with sitagliptin plus metformin, liraglutide plus metformin yielded an ICER of 267,985.96 RMB/QALY, which was below the predefined WTP threshold, indicating that it is cost-effective. One-way sensitivity analysis revealed that costs in the complication-free state for the intervention group, utility values for uncomplicated diabetes, and utility values for complicated diabetes had the greatest impacts on the ICER. Probabilistic sensitivity analysis showed that liraglutide plus metformin was cost effective for 63.6% of the iterations. Scenario analysis indicated that the economic advantage of liraglutide plus metformin became more pronounced as the price of liraglutide decreased.
Within the Chinese healthcare setting, for patients with T2DM inadequately controlled on metformin monotherapy, liraglutide plus metformin has a 63.6% probability of being cost-effective at the pre-specified WTP threshold, suggesting that the combination regimen is likely to be cost-effective.

PMID:
42630210
Bibliographic data and abstract were imported from PubMed on 22 Aug 2026.

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