We previously reported systematic reviews of DPP-4 inhibitors. Recently, the All Wales Medicines Strategy Group, the government agency charged with assessing the effectiveness of medicines and making recommendations about their use in the NHS in Wales, issued an evaluation of linagliptin, a DPP-4 inhibitor marketed under the brand name Trajenta.
In patients with type 2 diabetes inadequately controlled on metformin alone or who cannot take metformin, is linagliptin a cost-effective option for improving glycaemic control?
The review cites evidence submitted by the manufacturer. This comprised two Phase III trials, indirect comparisons with other treatment modalities, a cost-minimisation analysis and cost data.
This evidence was critiqued by the Group, who considered that it was “insufficiently robust” for them to recommend routine use of linagliptin in this context.
A detailed breakdown of the evidence and its critique is provided.
- The website does not provide detailed information about the methods of the review.
- Does this recommendation conform to AGREE principles?
- The judgment was made due to unfavourable direct cost comparison with alternative second-line therapies, particularly combination therapy of sitagliptin with metformin in a single capsule.
All Wales Medicines Strategy Group. Final Appraisal Recommendation, Advice No: 0112; Linagliptin (Trajenta®), Feburary 2012