@article{5d34d3d10a0343eeba070eab9ea64851,
title = "Longitudinal medical resources and costs among type 2 diabetes patients participating in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS)",
abstract = "Aims: TECOS, a cardiovascular safety trial (ClinicalTrials.gov identifier: NCT00790205) involving 14 671 patients with type 2 diabetes and cardiovascular disease, demonstrated that sitagliptin was non-inferior to placebo for the primary composite cardiovascular outcome when added to best usual care. This study tested hypotheses that medical resource use and costs differed between these 2 treatment strategies. Materials and methods: Information concerning medical resource use was collected on case report forms throughout the trial and was valued using US costs for: Medicare payments for hospitalizations, medical procedures and outpatient visits, and wholesale acquisition costs (WAC) for diabetes-related medications. Hierarchical generalized linear models were used to compare resource use and US costs, accounting for variable intercountry practice patterns. Sensitivity analyses included resource valuation using English costs for a UK perspective. Results: There were no significant differences in hospitalizations, inpatient days, medical procedures, or outpatient visits during follow-up (mean and median 3.0 years in both groups). Hospitalization rates appeared to diverge after 2 years, with lower rates among sitagliptin-treated vs placebo patients after 2.5 years (relative rate, 0.90 [95% CI, 0.83-0.97]; P =.01). Mean medical costs, exclusive of study medication, were 11 937 USD in the sitagliptin arm and 12 409 USD in the placebo arm (P =.06). Mean sitagliptin costs based on undiscounted WAC were 9978 USD per patient. Differential UK total costs including study drug costs were smaller (911 GBP), primarily because of lower mean costs for sitagliptin (1072 GBP). Conclusions: Lower hospitalization rates across time with sitagliptin slightly offset sitagliptin treatment costs over 3 years in type 2 diabetes patients at high risk for cardiovascular events.",
keywords = "cost analysis, costs, diabetes, dipeptidyl peptidase-4 inhibitor, sitagliptin",
author = "{for the TECOS Study Group} and Reed, {Shelby D.} and Yanhong Li and Jose Leal and Larry Radican and Adler, {Amanda I.} and Joakim Alfredsson and Buse, {John B.} and Green, {Jennifer B.} and Kaufman, {Keith D.} and Axel Riefflin and {Van de Werf}, Frans and Peterson, {Eric D.} and Gray, {Alastair M.} and Holman, {Rury R.}",
note = "Funding Information: S. D. R. has made available online a detailed listing of financial disclosures (http://www.dcri.duke.edu/about-us/conflict-of-interest/). J. B. B. has received consulting fees from PhaseBio and research support from AstraZeneca, Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb, Eli Lilly, GI Dynamics, GlaxoSmithKline, Intarcia Therapeutics, J&J, Lexicon, Medtronic Minimed, National Institutes of Health, Novo Nordisk, Orexigen, Sanofi, Scion NeuroStim, Takeda and Theracos; owns stocks/shares in PhaseBio; and has served as an advisor under contract with his employer for AstraZeneca, Dance Biopharm, Eli Lilly, Elcelyx, GI Dynamics, Lexicon, Merck, Metaven-tion, Novo Nordisk, Orexigen and vTv Therapeutics; and has received other support from Adocia, Insulin Algorithms, Dexcom, Fractyl, NovaTarg and Shenzen HighTide. J. B. G. has received grants from Merck, AstraZeneca and GlaxoSmithKline, grants and personal fees from Merck, other support from Boehringer-Ingelheim, and personal fees from Bioscientifica and The Endocrine Society. K. D. K. is an employee of Merck & Co., Inc., the manufacturer of sitagliptin, and owns stock and stock options in Merck & Co., Inc. L. R. is an employee of Merck & Co., Inc., the manufacturer of sitagliptin, and owns stock and stock options in Merck & Co., Inc. F. V. W. has received study grants and personal fees from Merck, Astra-Zeneca and Boehringer-Ingelheim. E. D. P. has received grants and personal fees from Janssen, grants from Eli Lilly and personal fees from AstraZeneca, Bayer and Sanofi. R. R. H. has received grants from AstraZeneca during the conduct of the study; and grants and personal fees from Bayer, Boehringer-Ingelheim and Merck, personal fees from Novartis, Amgen and Servier; and other support from Elcelyx, GlaxoSmithKline, Janssen and Takeda outside the submitted work. The other authors report no potential conflicts of interest relevant to this article. Funding Information: This study was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, New Jersey. Publisher Copyright: {\textcopyright} 2018 John Wiley & Sons Ltd",
year = "2018",
month = jul,
doi = "10.1111/dom.13292",
language = "English (US)",
volume = "20",
pages = "1732--1739",
journal = "Diabetes, Obesity and Metabolism",
issn = "1462-8902",
publisher = "Wiley-Blackwell",
number = "7",
}