Hi thank you for showing interest in our research my name is celia huang and i’m with my colleagues elizabeth sinoco and gina achmeyer we’re fourth year pharmacy students at ucsf and our research is titled cost-effectiveness analysis of amputation risk and cardiovascular benefits with can of glyphosate in patients with type 2 diabetes just to give you a bit
Of background canna glyphosate or brand name invocana is a sodium glucose transporter inhibitor canon glyphism has many indications but the indication pertinent to our study is the risk reduction of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease this indication emerged from the results of a 2017 study
Called the canon glyphism cardiovascular assessment study or canvas program the study demonstrated a significant increased amputation risk in patients taking cana glyphosate in addition to their background diabetes pharmacotherapy or bt compared to those on bt only this finding leads us to question does canon gleveson’s amputation risk reduces cost effectiveness
When compared to bt alone and secondly does canon glyphosate’s amputation risk outweigh its cardio keeping those questions in mind our project aimed to answer two objectives the primary was determining the incremental cost effectiveness ratio or icer of canada glyphosate in addition to background therapy otherwise referred to as cannables bt versus background
Therapy alone or bt on the basis of amputation risk and cv benefit the second was evaluating the minimum level of cardiovascular benefit required to offset the different amputation risks to answer these questions we constructed two six-state markov models using a payer perspective and an 84-month time horizon with the willingness to pay threshold or wtp of 100
000 the transition probabilities for both models were derived from the results provided in the canvas program the base case model was reflective of values found in literature while inputs for the maximum better fit model will derive to be a mathematical manipulation of those used for the base case model ultimately the intent for the latter model was to provide
The maximum chance for cataclysm to demonstrate its cost effectiveness here you can see the specific costs and utility values used to create the markup models everyone entering the model received a baseline cost for standard diabetes pharmacotherapy and adverse events those going into the treatment group received a monthly cost for cataglyphism and depending
On the translational probabilities each hypothetical person received an additional cost per event experience interestingly what we found in our base case model was that canoglyphism plus bt was not cost effective compared to bt alone the icer for canoglyphism exceeded the wtp threshold at a value of one million two hundred ninety four thousand and three hundred
And seventy dollars sensitivity analysis for the probability of amputation and non-fatal mi and stroke in canada glyphosate plus bt were conducted using a range of probabilities around the reference value demonstrated icers above the wtp threshold throughout the ranges similarly our maximum benefits model demonstrated canon glyphosin plus bt was again not cost
Effective compared to bt alone the iso for canon glyphosate exceeded the wtp at a value of 524 and 220 dollars three sensitivity analyses were conducted the first sensitivity analysis for the probability of amine stroke was performed by running a hundred percent below and 25 above the average probability of having a cv event canada glyphs and plus bt was not
Cost effective at probabilities exceeding 0.0064 which included our reference value the second sensitivity analysis examined canon glyphosate plus bt’s cost effectiveness from a range of probabilities which was not cost effective the last sensitivity analysis examined canada glyphosate plus bt’s cost effectiveness from a range of cantaloupes and costs and found
That canada glyphosate was not cost-effective from cost exceeding 64.75 which included our reference value so what did we learn the cv benefits awarded by canon glyphizen did not translate to canon glyphosate being cost effective in the base case scenario or in our maximum benefit scenario demonstrating that the high drug cost of canada glyphosate was a strong
Driver in these short-term models our model was not sensitive to the trade-offs and probability of amputation and cv risk with the use of canon glyphosate and was never cost effective compared to bt although the short-term models suggest canon glyphosate was not cost-effective in a high cv risk population with diabetes canna glyphosate may provide benefit to some
Patients with type 2 diabetes and high risk for cv events more published information is needed about the extent and lifetime cost of amputation and long-term cv benefits future cost effectiveness studies should track cv benefits and amputation risk over lifetime thank you again for showing interest in our research for questions please don’t hesitate to email you
Transcribed from video
CSHP 2020 Canagliflozin CEA By Gina Ahmadyar