Once-weekly semaglutide for patients with type 2 diabetes: a cost-effectiveness analysis in the Netherlands.

Abstract

Objective:

Choosing therapies for type 2 diabetes that are both effective and cost-effective is vital as healthcare systems worldwide aim to maximize health of the population. The present analysis assessed the cost-effectiveness of once-weekly semaglutide (a novel glucagon-like peptide-1 (GLP-1) receptor agonist) versus insulin glargine U100 (the most commonly used basal insulin) and versus dulaglutide (an alternative once-weekly GLP-1 receptor agonist), from a societal perspective in the Netherlands.

Research design and methods:

The IQVIA CORE Diabetes Model was used to project outcomes for once-weekly semaglutide 0.5 mg and 1 mg versus insulin glargine U100, once-weekly semaglutide 0.5 mg versus dulaglutide 0.75 mg, and once-weekly semaglutide 1 mg versus dulaglutide 1.5 mg. Clinical data were taken from the SUSTAIN 4 and SUSTAIN 7 clinical trials. The analysis captured direct and indirect costs, mortality, and the impact of diabetes-related complications on quality of life.

Results:

Projections of outcomes suggested that once-weekly semaglutide 0.5 mg was associated with improved quality-adjusted life expectancy by 0.19 quality-adjusted life years (QALYs) versus insulin glargine U100 and 0.07 QALYs versus dulaglutide 0.75 mg. Once-weekly semaglutide 1 mg was associated with mean increases in quality-adjusted life expectancy of 0.27 QALYs versus insulin glargine U100 and 0.13 QALYs versus dulaglutide 1.5 mg. Improvements came at an increased cost versus insulin glargine U100, with incremental cost-effectiveness ratios from a societal perspective of €4988 and €495 per QALY gained for once-weekly semaglutide 0.5 mg and 1 mg, respectively, falling below Netherlands-specific willingness-to-pay thresholds. Improvements versus dulaglutide came at a reduced cost from a societal perspective for both doses of once-weekly semaglutide.

Conclusions:

Once-weekly semaglutide is cost-effective versus insulin glargine U100, and dominant versus dulaglutide 0.75 and 1.5 mg for the treatment of type 2 diabetes, and represents a good use of healthcare resources in the Netherlands.

• Authors: Barnaby Hunt, Samuel J P Malkin, Robert G J Moes, Eline L Huisman, Tom Vandebrouck, Bruce H R Wolffenbuttel
• Journal: BMJ open diabetes research & care (BMJ Open Diabetes Res Care) Vol. 7 Issue 1 Pg. e000705 ( 2019) ISSN: 2052-4897 [Print] England
• PMID: 31641522 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Biomarkers
• Blood Glucose
• Hypoglycemic Agents
• Insulin Glargine
• semaglutide
• Glucagon-Like Peptides

Topics

• Biomarkers (analysis)
• Blood Glucose (analysis)
• Cost-Benefit Analysis
• Diabetes Mellitus, Type 2 (drug therapy, economics, epidemiology)
• Female
• Follow-Up Studies
• Glucagon-Like Peptides (economics, therapeutic use)
• Humans
• Hypoglycemic Agents (economics, therapeutic use)
• Insulin Glargine (economics, therapeutic use)
• Life Expectancy
• Male
• Middle Aged
• Netherlands (epidemiology)
• Prognosis
• Quality of Life