Objective: Type 2 diabetes mellitus (T2DM) in Mexico is a public health problem due to its high prevalence (in 2020 15.7%) and a continuing healthcare challenge. For Mexico, adding new and effective treatments is crucial to ensure that healthcare resources are used efficiently. The present analysis assessed the cost-effectiveness of once-weekly Semaglutide versus available GLP-1 RA, SGLT-2 and DPP-4i therapies in Mexico, for the treatment of patients with type 2 diabetes mellitus with inadequate glycaemic control.

Methods: A Markov model baseline cohort characteristics and treatment effects was developed using indirect comparison and head-to-head clinical trial comparing therapies available in the Mexican public sector formulary. The analysis captured pharmacological costs and costs of diabetes-related complications, expressed in 2022 USD. The outcome measured is the total costs (direct medical costs) and proportion of complications-free patients. Projected outcomes were discounted at 5% annually. A probabilistic sensitivity analysis was developed to assess the robustness of the case base results. Time horizon 10 years.

Results: Projections of long-term clinical outcomes in patients with inadequate glycemic control indicated that oral Semaglutide was associated with improved clinical outcomes (due to reduced cumulative incidence and delayed time to onset of diabetes-related complications). Complications-free patients with Semaglutide were 51.5% meanwhile GLP-1 RA 45.5% SGLT-2 42.6% and DPP-4 were 38.3%. Regarding costs (and associated to its efficacy), Semaglutida has a lower cost when compared to available GLP-1 RA therapies in Mexico ($17,173 vs $18,228 GLP-1 RA). The cost-effectiveness base case analysis indicates that Semaglutide for the tretament of T2DM is a dominant alternative (more effectiveness, less cost). The results of the probabilistic sensitivity analysis showed to be consistent to the base case analysis.

Conclusions: Oral Semaglutide is considered a dominant treatment option compared with GLP-1 RA, SGLT-2 and DPP-4i in the treatment of patients with type 2 diabetes in Mexico.