OBJECTIVES

Type 2 diabetes represents a continuing healthcare challenge, and choosing cost-effective treatments is crucial to ensure that limited healthcare resources are used efficiently. The present analysis assessed the long-term cost-effectiveness of once-weekly semaglutide 1 mg versus empagliflozin 25 mg for the treatment of patients with type 2 diabetes mellitus with inadequate glycemic control on metformin monotherapy from a healthcare payer perspective in the UK.

METHODS

Outcomes were projected over patient lifetimes using the IQVIA CORE Diabetes Model. Baseline cohort characteristics and treatment effects on initiation of once-weekly semaglutide 1 mg and empagliflozin 25 mg were based on an indirect comparison conducted using patient-level data, as there is currently no head-to-head clinical trial comparing the two therapies. Patients received both treatments until glycated hemoglobin exceeded 7.5%, at which point patients initiated basal insulin. The analysis captured pharmacy costs and costs of diabetes-related complications, expressed in 2019 pounds sterling (GBP). Utilities from published sources were applied to calculate quality-adjusted life expectancy. Projected outcomes were discounted at 3.5% annually.

RESULTS

Once-weekly semaglutide 1 mg was associated with increases in life expectancy and quality-adjusted life expectancy of 0.12 years and 0.23 quality-adjusted life years (QALYs), respectively, compared with empagliflozin 25 mg. Improvements in quality and duration of life resulted from a reduced cumulative incidence and a delayed time to onset of diabetes-related complications. Once-weekly semaglutide was associated with increased pharmacy costs, but this was partially offset by avoided costs of treating complications. Once-weekly semaglutide was associated with a mean increase in costs of GBP 1,017, leading to an incremental cost-effectiveness ratio of GBP 4,439 per QALY gained.

CONCLUSIONS

Once-weekly semaglutide 1 mg is likely to be a cost-effective treatment from a healthcare payer perspective compared with empagliflozin 25 mg for the treatment of patients with type 2 diabetes in the UK setting.