Cardiovascular outcomes and healthcare costs of liraglutide versus basal insulin for type 2 diabetes patients at high cardiovascular risk.

Abstract	We aimed to compare the (1) clinical outcomes including composite cardiovascular outcomes, cardiovascular death, and all-cause death, and (2) healthcare costs of using liraglutide and basal insulin as an initial treatment for patients with type 2 diabetes mellitus (T2DM) and high cardiovascular diseases (CVD) risk. This is a retrospective cohort study using Taiwan's Health and Welfare Database. A total of 1057 patients treated with liraglutide were identified and matched with 4600 patients treated with basal insulin. The liraglutide group had a lower risk of a composite CVD outcome (hazard ratio (HR) 0.65; 95% confidence interval (CI) 0.50-0.85; p < 0.01), all-cause mortality (HR 0.40; 95% CI 0.28-0.59; p < 0.0001), and nonfatal stroke (HR 0.54; 95% CI 0.34-0.87; p = 0.01). Compared to the basal insulin group, the liraglutide group had lower median per-patient-per-month (PPPM) inpatient, emergency room (ER), and total medical costs, but higher median PPPM outpatient, total pharmacy, and total costs (all p < 0.0001). In conclusion, compared to basal insulin, liraglutide was found to be associated with reduced risk of a composite CVD outcome, nonfatal stroke, and all-cause mortality among high CVD risk patients with T2DM. In addition, liraglutide users had lower inpatient, ER, and total medical costs, but they had higher outpatient and total pharmacy costs.
Authors	Wan-Chun Huang, Yen-Chou Chen, Chung-Hsuen Wu, Yu Ko
Journal	Scientific reports (Sci Rep) Vol. 11 Issue 1 Pg. 1430 (01 14 2021) ISSN: 2045-2322 [Electronic] England
PMID	33446845 (Publication Type: Comparative Study, Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
Chemical References	Insulin Detemir Liraglutide
Topics	Aged Cardiovascular Diseases (drug therapy, economics, mortality) Diabetes Mellitus, Type 2 (drug therapy, economics, mortality) Female Health Care Costs Humans Insulin Detemir (administration & dosage, economics) Liraglutide (administration & dosage, economics) Male Middle Aged Retrospective Studies Risk Factors Taiwan (epidemiology)

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