OBJECTIVES

Healthcare providers must choose cost-effective therapies for type 2 diabetes in order to optimize health outcomes with limited resources. This 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 Bosnia and Herzegovina, Greece, and Slovenia.

METHODS

The IQVIA CORE Diabetes Model was used to project outcomes over patient lifetimes, with baseline patient characteristics and treatment effects of once-weekly semaglutide 1 mg and empagliflozin 25 mg based on an indirect comparison conducted using patient-level data. In the modeling analysis, both therapies were discontinued and basal insulin initiated when glycated hemoglobin exceeded 7.5%. Country-specific costs of medications and complications were applied, as were utilities. Country-specific discount rates were applied to projected outcomes.

RESULTS

Over patient lifetimes, once-weekly semaglutide 1 mg was associated with quality-adjusted life expectancy increases versus empagliflozin 25 mg of 0.19, 0.21, and 0.21 quality-adjusted life years (QALYs) in Bosnia and Herzegovina, Greece, and Slovenia, respectively. In Greece, cost savings due to avoided complications entirely offset increased pharmacy costs, with once-weekly semaglutide associated with cost savings of EUR 1,767. In Bosnia and Herzegovina and Slovenia, increased pharmacy costs were only partially offset by avoided complication costs, with once-weekly semaglutide associated with mean cost increases of EUR 853 and EUR 880, respectively. Once-weekly semaglutide was considered dominant versus empagliflozin in Greece, and was associated with incremental cost-effectiveness ratios of EUR 4,397 and EUR 4,122 per QALY gained in Bosnia and Herzegovina and Slovenia, respectively.

CONCLUSIONS

In Bosnia and Herzegovina, Greece, and Slovenia, once-weekly semaglutide is likely to be to be a cost-effective therapy from a healthcare payer perspective compared with empagliflozin 25 mg for the treatment of patients with type 2 diabetes.