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Insulin therapy is associated with weight gain and hypoglycemia, and patients and physicians generally prefer to postpone insulin use. SGLT2 inhibitors provide substantial and sustained HbA1c lowering, weight loss, and blood pressure control in patients with T2DM, and are generally well tolerated. Indirect comparisons of clinical trial data suggest that these agents have differential efficacy.
Long-term data are rarely available when reimbursement decisions are made for T2DM therapies. If properly constructed and applied, economic simulation models can be useful tools for decision-making. To engender confidence that model results reflect reality as best as possible, the ability to replicate results from actual clinical studies should be assessed through formal validity testing.
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