Therapeutic Review of Third-Line Drugs for Type 2 Diabetes — An Update

In 2017, CADTH began preliminary work on a Therapeutic Review to assess new third-line drug therapies for type 2 diabetes and provide recommendations on their optimal use. The drugs included in this review included dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 analogues, and sodium-glucose cotransporter-2 inhibitors.

In January 2018, we elected to pause the review after considering feedback from our stakeholders and taking other factors into account.

Why has work on this Therapeutic Review paused at this time?

The timing of our review and the data available to us at the beginning of the project raised concerns that the review would not adequately capture cardiovascular outcomes that we know are particularly important to the patients, clinicians, and policy-makers who are impacted by our work.

Throughout 2018 and 2019, results from several pivotal randomized controlled trials will be available, including ones examining cardiovascular outcomes. By waiting until we have access to this emerging data, we can provide a more rigorous and comprehensive review of both the clinical and economic evidence.

Further, we received significant stakeholder feedback regarding our use of an A1C-based economic model for our cost-effectiveness analysis. By pausing our work now, we can explore best practices around updating our economic model to incorporate cardiovascular outcomes data.

We thank all stakeholders who provided input and feedback into this project.

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