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Canadian Drug Review Reimbursement Decision

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Generic liraglutide
Company Novo Nordisk Canada Inc.
Indication diabetes
Condition Endocrine, nutritional and metabolic diseases
Submission Type
Patient Population Liraglutide has a Health Canada indication for the treatment of adults with type 2 diabetes mellitus to improve glycemic control in combination with: • metformin, when diet and exercise plus maximal tolerated dose of metformin do not achieve adequate glycemic control, or • metformin and a sulfonylurea, when diet and exercise plus dual therapy with metformin and a sulfonylurea do not achieve adequate glycemic control. Liraglutide is an analog of human glucagon-like peptide-1, the first of a new class of hypoglycemic agents. It is available as a 6 mg/mL solution for subcutaneous (SC) injection in a pre-filled pen. The recommended starting dose is 0.6 mg SC once daily. After one week, the dose should be increased to 1.2 mg SC once daily. Based on clinical response after at least one week, the dose can be increased to 1.8 mg SC once daily.
Status Complete
Date of Recommendation 2011-09-28
Recommendation Summary Do not list
Recommendation Details The Canadian Expert Drug Advisory Committee (CEDAC) recommends that liraglutide not be listed at the submitted price
Reason for Recommendation 1. Based on a systematic review including six randomized controlled trials (RCTs), liraglutide demonstrated similar or greater reductions in hemoglobin A1c in combination with metformin, or with metformin and a sulfonylurea, compared with antihyperglycemic agents from other drug classes. Liraglutide was also associated with statistically significant weight loss compared with other drug classes. The clinical significance of these results with respect to diabetes-related morbidity and mortality is unknown for this new class of drug therapy. 2. The daily cost of liraglutide ($4.89 to $7.34) is greater than sulfonylureas (< $1.00), thiazolidinediones (< $3.00), dipeptidyl peptidase-4 (DPP-4) inhibitors (< $3.00), insulin NPH (< $2.00), and insulin analogues (< $3.00). Of Note: Based on a review of the clinical evidence, the Committee noted that a reduced price would increase the likelihood of a recommendation to “list with criteria” for patients with inadequate glycemic control on metformin and a sulfonylurea. The Committee noted insulin NPH was the most appropriate comparator for this patient population
Clinical Report:
Pharmacoeconomic Report:
Final Recommendation Report: CDR clinical report  CADTH-CDR Final Recommendation report

†The information referenced on this page is compiled from publicly available documents published by CADTH and is available through the embedded links.

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