Evaluation of the long-term cost-effectiveness of once-weekly semaglutide versus dulaglutide for treatment of type 2 diabetes mellitus in the UK

Adie Viljoen, Christina S Hoxer, Pierre Johansen, Samuel Malkin, Barnaby Hunt, Stephen C Bain, Adie Viljoen, Christina S Hoxer, Pierre Johansen, Samuel Malkin, Barnaby Hunt, Stephen C Bain

Abstract

Aims: Glucagon-like peptide-1 (GLP-1) receptor agonists are appealing as glucose-lowering therapy for individuals with type 2 diabetes mellitus (T2DM) as they also reduce body weight and are associated with low rates of hypoglycaemia. This analysis assessed the long-term cost-effectiveness of semaglutide 0.5 and 1 mg vs dulaglutide 1.5 mg (two once-weekly GLP-1 receptor agonists) from a UK healthcare payer perspective, based on the head-to-head SUSTAIN 7 trial, to inform healthcare decision making.

Materials and methods: Long-term outcomes were projected using the IQVIA CORE Diabetes Model (version 9.0). Baseline cohort characteristics, changes in physiological parameters and adverse event rates were derived from the 40-week SUSTAIN 7 trial. Costs to a healthcare payer were assessed, and these captured pharmacy costs and costs of complications. Utilities were taken from published sources.

Results: Once-weekly semaglutide 0.5 and 1 mg were associated with improvements in quality-adjusted life expectancy of 0.04 and 0.10 quality-adjusted life years, respectively, compared with dulaglutide 1.5 mg. Clinical benefits were achieved at reduced costs, with lifetime cost savings of GBP 35 with once-weekly semaglutide 0.5 mg and GBP 106 with the once-weekly semaglutide 1 mg, resulting from fewer diabetes-related complications due to better glycaemic control. Therefore, both doses of once-weekly semaglutide were considered dominant vs dulaglutide 1.5 mg (improving outcomes and reducing costs).

Conclusions: Compared with treatment with dulaglutide, once-weekly semaglutide represents a cost-effective option for treating individuals in the UK with T2DM who are not achieving glycaemic control with metformin, projected to both improve clinical outcomes and reduce costs.

Keywords: GLP-1 analogue; antidiabetic drug; cost-effectiveness; incretin therapy.

Conflict of interest statement

Author contributions

The study was designed by all authors. B. H. and S. M. conducted the study. All authors contributed to analysis of the results. S. M. and B. H. drafted the manuscript and A. V., S. C. B., C. S. H and P. J. critically reviewed the manuscript and revised it for important intellectual content. All authors approved the final manuscript and agree to be accountable for all aspects of the work.

© 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
Cost‐effectiveness acceptability curve from the probabilistic sensitivity analysis. Abbreviations: GBP, 2016 pounds sterling; QALY, quality‐adjusted life year

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