NICE recommends ertugliflozin monotherapy as an option for treating type II diabetes in adults for whom metformin is contraindicated or not tolerated and when diet and exercise alone do not provide adequate glycaemic control, only if:
- a dipeptidyl peptidase 4 (DPP-4) inhibitor would otherwise be prescribed and
- a sulfonylurea or pioglitazone is not appropriate.
Ertugliflozin is also recommended by NICE for use in combination with metformin as an option when:
- a sulfonylurea is contraindicated or not tolerated or
- the person is at significant risk of hypoglycaemia or its consequences.
NICE's recommendation was based on the results of three pivotal trials, VERTIS-MONO, VERTIS-MET and VERTIS-FACTORIAL, in which patients treated with ertugliflozin as monotherapy or as dual therapy with metformin showed significant reductions in HbA1c from baseline to week 26 compared with patients given placebo.
In its assessment, NICE concluded that the acquisition cost of ertugliflozin is lower than that of other SGLT2 inhibitors while the overall health benefits are similar.