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.
- non-insulin dependent diabetes mellitus
- glucagon-like peptide-1 (GLP-1)
- cost effectiveness
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Contributors The study was conceived and designed by all authors and conducted by BH. BH drafted the manuscript, which was reviewed and revised by all authors. All authors had full access to the study data and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding The study was supported by funding from Novo Nordisk Region Europe Pharmaceuticals A/S.
Competing interests SJPM and BH are employees of Ossian Health Economics and Communications. Ossian received consulting fees from Novo Nordisk Region Europe Pharmaceuticals A/S to support preparation of the analysis. RGJM and ELH are employees of Novo Nordisk BV. TV is an employee of SA Novo Nordisk Pharma. BW has received grant support for clinical studies and also consulting fees for serving on advisory boards and as a speaker for Amgen, Ascensia, AstraZeneca, Eli Lilly and Company, Novo Nordisk, Pfizer and Sanofi. He has also received consulting fees from Eli Lilly and Company as a member of the 4B study and of the DURABLE Trial Data Monitoring Committee, and from Novo Nordisk as principal investigator for the SURE Study Netherlands.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.
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