Silas Martin, director of Health Economics and Outcomes Research at Janssen Scientific Affairs, discusses canagliflozin and how it may reduce long-term health costs associated with type 2 diabetes.
Hello i am silas martin i’m from janssen scientific affairs and i’m a director of health economics and outcomes research and i together with my colleagues from janssen and some colleagues from the swedish institute of health economics presented recently a an analysis at the american diabetes association in chicago and what we did at that with that analysis was we
Took some information from a phase three clinical study that was a twenty six weeks in length and took the outcomes of those study of that study to predict sort of the long term health economic outcomes and costs that one could expect over a lifetime from those patients using a you know a cohort of simulated patients and also using a validated health economic model
So what this what this did was it took the results of the study so for example the hba1c reductions the blood pressure reductions the weight reductions as well as some of the lipid changes and infection rates over the twenty six week period and then took that result and then began to extrapolate further using this validated model to predict these outcomes and over
The time of the simulation what what happens is when a patient our simulated patient gets below gets above the threshold of a hba1c then we model actually treatment intensification over time so to give you a flavor of that yeah throughout the simulation at year one we saw that 20% and thirteen percent of the patients simulated to take one hundred and three hundred
Milligrams of kanaka flows and would progress their therapy versus forty three percent of those patients that were on lifestyle management alone and did not start a treatment sequence with invokana so we’re actually comparing like in the trial a treatment sequence that begins with invokana or chemical flows and verses a treatment sequence that did not begin with
A moca so then so the progression continues and over the course of time you see these cumulative effects of reductions in or just accumulative effects of simulated events and what we observe is that over this 30 year time horizon that there is a relative risk reduction for the patients that started with the treatment with kanaka flows and relative to not with
Kind of close and sort of lifestyle management alone and that’s on the order of about 36% for micro vascular events which are you know have been associated with the uncontrolled blood sugar and those things can be though those are those are things like vision problems or nerve damage or kidney damage so that’s significant outcomes as well as we we did simulate
Macro vascular events as well so we saw some reductions on the order of 5 to 17 percent and those events so you know coupled with those events are our costs that can accrue over time as well so that’s the second part of this health economic analysis is the cost piece and over that that treatment sequence we observe some cost reductions as well for the treatment
Arm starting with evo kanna on the order of about $4,000 for the 100 or about $5,500 for the 300 so this these are again simulated results of hypothetical patients but can give a flavor of the of the long-term expectations of the drug given we don’t have data that extends that over that period of time we have short term data right now but what what it what it
Means is that decision-makers are trying to think about what what to do with this new class and this new you know drug in the new class and trying to make decisions about how to make it available to patients and so this type of analysis can give a window into those expectations over a longer period of time how this can be impactful for decision-makers is it like
It can it can help understand the long term implications of the drug when we only have phase 3 data in hand chemical flows in was was studied in over 10,000 patients across a wide variety of settings from mono therapy all the way through to with insulin but again we only have shorter term data right now and this type of simulated environments without you know
Having to follow patients and wait over that long period of time for patients to kind of express those outcomes we can get an idea of what what the value can be to a to a health system additionally this is the first in a new class of agents which acts on the kidney current agents act more outside the kidney and the way this acts is that it acts on a the reuptake
Of glucose so in the in the kidney there is normal exhorting of glucose and then reabsorption of glucose and that actually contributes to the dysregulation of glucose in in type 2 diabetes and so what this drug does is it prevents the reabsorption of glucose in the kidney to some degree and promotes the excretion of that glucose into the urine and in that way can
Lower blood sugar and also leads to some of the other other benefits like reductions in blood pressure reduction wait i think can also lead to some increased infection rates or you know it over the over the of the course of the trial we observed an increase of about 10% in infection rates but many of these infections lead to do not lead to discontinuation so we
Did a lot we ended analysis we simulated all of these elements of the drug the benefits and the risks to kind of give again this window into what could it be expected over the over the over the period of using the drug
Transcribed from video
Canagliflozin and health costs of type 2 diabetes By Formulary Mag
