A comparative analysis of cost-utility: Chiglitazar vs. sitagliptin in patients with type 2 diabetes in China

As a structurally unique peroxisome proliferator-activated receptor pan-agonist, chiglitazar has showed dual therapeutic benefits for glycemic control and lipid management in type 2 diabetes mellitus (T2DM). Despite these clinical advantages, comprehensive pharmacoeconomic evaluations comparing chiglitazar with conventional therapies like sitagliptin remain unavailable for China's healthcare system.

This study aimed to conduct a comparative cost-utility analysis of chiglitazar versus sitagliptin for T2DM treatment in China, evaluating long-term clinical and economic outcomes from a healthcare system perspective.

Data on patient demographics and post-treatment effects were collected from a double-blind, phase 3, randomized controlled trial conducted in China. The United Kingdom Prospective Diabetes Study Outcomes Model 2.1 was employed to evaluate the long-term effectiveness and associated costs. Uncertainties were addressed using one-way and probabilistic sensitivity analyses. Additionally, the binary search method was utilized to estimate an optimal annual cost for sitagliptin in scenario analyses.

After a 40-year simulation, the life expectancy results were comparable among treatments: 14.93 years for chiglitazar 32 mg, 14.94 years for chiglitazar 48 mg, and 14.93 years for sitagliptin 100 mg. The corresponding quality-adjusted life years (QALYs) reached 12.82, 12.83, and 12.81, respectively. Total accumulated costs over the simulation period were $44,241.09 (chiglitazar 32 mg), $45,044.25 (chiglitazar 48 mg), and $44,821.45 (sitagliptin 100 mg). Long-term economic evaluation revealed that chiglitazar 32 mg provided the optimal cost-effectiveness, whereas sitagliptin 100 mg was the least economically advantageous option. Both one-way and probabilistic sensitivity analyses confirmed the robustness of these findings. Scenario analysis showed that sitagliptin 100 mg only becomes cost-effective when its annual cost is reduced by at least 42.33 % compared to chiglitazar 32 mg.

Based on cost-utility analysis within the Chinese healthcare context, chiglitazar demonstrates significantly better long-term health outcomes and cost-effectiveness relative to sitagliptin for T2DM management.