The long-term cost-effectiveness of once-weekly semaglutide 1 mg vs. dulaglutide 3 mg and 4.5 mg in the UK

Adie Viljoen, Barrie Chubb, Samuel J. P. Malkin (), Sasha Berry, Barnaby Hunt and Stephen C. Bain
Additional contact information
Adie Viljoen: Lister Hospital (East and North Hertfordshire NHS Trust)
Barrie Chubb: Novo Nordisk Ltd
Samuel J. P. Malkin: Ossian Health Economics and Communications GmbH
Sasha Berry: Novo Nordisk Ltd
Barnaby Hunt: Ossian Health Economics and Communications GmbH
Stephen C. Bain: Swansea University Medical School

The European Journal of Health Economics, 2023, vol. 24, issue 6, No 5, 895-907

Abstract: Abstract Aims Once-weekly semaglutide and dulaglutide represent two highly efficacious treatment options for type 2 diabetes. A recent indirect treatment comparison (ITC) has associated semaglutide 1 mg with similar and greater improvements in glycated haemoglobin (HbA1c) and body weight, respectively, vs. dulaglutide 3 mg and 4.5 mg. The present study aimed to evaluate the long-term cost-effectiveness of semaglutide 1 mg vs. dulaglutide 3 mg and 4.5 mg in the UK. Materials and methods The IQVIA CORE Diabetes Model (v9.0) was used to project outcomes over patients’ lifetimes. Baseline cohort characteristics were sourced from SUSTAIN 7, with changes in HbA1c and body mass index applied as per the ITC. Modelled patients received semaglutide or dulaglutide for 3 years, after which treatment was intensified to basal insulin. Costs (expressed in 2020 pounds sterling [GBP]) were accounted from a healthcare payer perspective. Results Semaglutide 1 mg was associated with improvements in quality-adjusted life expectancy of 0.05 and 0.04 quality-adjusted life years (QALYs) vs. dulaglutide 3 mg and 4.5 mg, respectively, due to a reduced incidence of diabetes-related complications with semaglutide. Direct costs were estimated to be GBP 76 lower and GBP 8 higher in the comparisons with dulaglutide 3 mg and 4.5 mg, respectively. Overall outcomes were similar, but favoured semaglutide, and based on modelled mean outcomes it was considered dominant vs. dulaglutide 3 mg and associated with an incremental cost-effectiveness ratio of GBP 228 per QALY gained vs. dulaglutide 4.5 mg. Conclusions Semaglutide 1 mg represents a cost-effective treatment vs. dulaglutide 3 mg and 4.5 mg for type 2 diabetes from a healthcare payer perspective in the UK.

Keywords: Cost; Cost-effectiveness; Semaglutide; Dulaglutide; UK (search for similar items in EconPapers)
JEL-codes: D61 I19 (search for similar items in EconPapers)
Date: 2023
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DOI: 10.1007/s10198-022-01514-1

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