OBJECTIVES: To assess the long-term cost-effectiveness of once-weekly (OW) semaglutide 0.5mg and 1.0mg versus Polyethylene Glycol Loxenatide (PEG-Loxenatide) 0.2mg (a Chinese self-developed once-weekly GLP-1RA) among patients with type 2 diabetes (T2D) in Chinese setting.

METHODS: The Swedish Institute of Health Economics Diabetes Cohort Model (IHE-DCM, V4.4.2) was used to evaluate the long-term health and economic outcomes between OW semaglutide versus PEG-Loxenatide. Analysis was conducted from the perspective of Chinese healthcare systems over a time horizon of 40 years. Baseline cohort characteristics were sourced from the SUSTAIN China clinical trial. Baseline risks of complications were sourced from previous publication. A network meta-analysis (NMA) based on two placebo-controlled phase 3a clinical trials, which assessed the efficacy of OW semaglutide and PE-Loxenatide respectively, was conducted to obtain the treatment effects of OW semaglutide and PEG-Loxenatide. Pharmaceutical costs were sourced from national bidding price in China. Costs of complications and utilities associated with diabetes and diabetes-related complications were taken from published sources. Costs were expressed in 2021 China Yuan (CNY). Health and economic outcomes were discounted at a rate of 5% annually. Sensitivity analyses were conducted to assess the robustness of the results.

RESULTS: Compared with PEG-Loxenatide 0.2mg, OW semaglutide 0.5mg and 1.0mg were associated with increase discounted life expectancy of 0.08 years and 0.12 years, and with increased discounted quality-adjusted life expectancy of 0.16 QALYs and 0.22 QALYs, respectively. Clinical benefits were achieved at reduced costs, with lifetime cost savings of 19,309 CNY with OW semaglutide 0.5 mg and 10,179 CNY with OW semaglutide 1.0 mg. Sensitivity analyses verified the robustness of the research results.

CONCLUSIONS: Compared with treatment with PEG-Loxenatide, once-weekly semaglutide represents a dominant option for treating patients with T2D in China who are not achieving glycemic control with metformin, projected to both improve clinical outcomes and reduce costs.