Cost-effectiveness of oral semaglutide added to current antihyperglycemic treatment for type 2 diabetes

Guzauskas, Gregory F.; Rind, David M.; Fazioli, Katherine; Chapman, Richard H.; Pearson, Steven D.; Hansen, Ryan N.

doi:10.18553/jmcp.2021.27.4.455

Cited by 14 publications

(13 citation statements)

References 25 publications

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“…Rose et al also noted a significant increase in the monthly cost of hypoglycemic agents after initiating GLP-1 analogues ( Rose et al, 2020 ). Our study found that Semaglutide had higher cost and comparable outcomes with regard to HbA1C reductions compared to other diabetes treatments, a finding that contrasts with some studies while aligning with others ( Ramos et al, 2020 , Ehlers et al, 2022 , Guzauskas et al, 2021 , Gorgojo-Martínez et al, 2020 , Bain et al, 2020 , Hunt et al, 2019 , Capehorn et al, 2021 ).…”

Section: Discussioncontrasting

confidence: 65%

Cost consequence analysis of adding semaglutide to treatment regimen for patients with Type II diabetes in Saudi Arabia

AlRuthia,

Hani Aburisheh,

Ata

et al. 2024

Saudi Pharmaceutical Journal

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Section: Discussioncontrasting

confidence: 65%

Cost consequence analysis of adding semaglutide to treatment regimen for patients with Type II diabetes in Saudi Arabia

AlRuthia,

Hani Aburisheh,

Ata

et al. 2024

Saudi Pharmaceutical Journal

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“…Studies in multiple countries have also variously found oral or s.c. formulations of semaglutide to be cost-effective compared with medications such as insulin, empagliflozin, liraglutide, and dulaglutide for the treatment of T2D [28][29][30][31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Impact of BMI and comorbidities on efficacy of once‐weekly semaglutide: Post hoc analyses of the STEP 1 randomized trial

McGowan

Houshmand-Oeregaard

Laursen

et al. 2023

Obesity

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Objective: This study assessed the effects of semaglutide on body weight, cardiometabolic risk factors, and glycemic status in individuals categorized by baseline BMI with or without additional obesity-related comorbidities, including prediabetes and high risk of cardiovascular disease (CVD).Methods: This was a post hoc exploratory subgroup analysis of the Semaglutide Treatment Effect in People with Obesity (STEP) 1 trial (NCT03548935), in which participants without diabetes and BMI ≥30 kg/m 2 , or BMI ≥27 kg/m 2 with ≥1 weightrelated comorbidity, were randomized to once-weekly subcutaneous semaglutide 2.4 mg or placebo for 68 weeks. For this analysis, individuals were categorized into subgroups based on baseline BMI <35 versus ≥35 kg/m 2 (with no additional criteria, with ≥1 comorbidity, with prediabetes, and with prediabetes and high risk of CVD).Results: Mean changes in body weight from baseline to week 68 with semaglutide were À16.2% and À14.0% in the subgroups with baseline BMI <35 and ≥35 kg/m 2 , respectively (both p < 0.0001 vs. placebo). Similar changes were observed in individuals with comorbidities, with prediabetes, and with prediabetes plus high CVD risk.The beneficial effects of semaglutide on cardiometabolic risk factors were consistent across all subgroups.Conclusions: This subgroup analysis confirms that semaglutide is effective in individuals with baseline BMI <35 and ≥35 kg/m 2 , including in those with comorbidities.

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“… 29 , 30 or reduction in health event probabilities (e.g., myocardial infarction [MI], stroke). 31 , 32 Prior work has demonstrated that the health effects of GLP1RA or SGLT2I are not fully captured by reductions in risk factors. 33 , 34 Thus, we chose to model the direct reduction in health event probabilities for the base-case analysis, to allow for a maximum estimate of drug benefit.…”

Section: Methodsmentioning

confidence: 99%

Expected Health Benefits of SGLT-2 Inhibitors and GLP-1 Receptor Agonists in Older Adults

Dadwani

Wan

Skandari

et al. 2023

MDM Policy & Practice

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Background. Older and sicker adults with type 2 diabetes (T2D) were underrepresented in randomized trials of glucagon-like peptide 1 receptor-agonist (GLP1RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2I), and thus, health benefits are uncertain in this population. Objective. To assess the impact of age, health status, and life expectancy in older adults with T2D on health benefits of GLP1RA and SGLT2I. Design. We used the United Kingdom Prospective Diabetes Study (UKPDS) model to simulate lifetime health outcomes. We calibrated the UKPDS model to improve mortality prediction in older adults using a common geriatric prognostic index. Participants. National Health and Nutrition Examination Survey 2013–2018 participants 65 y and older with T2D, eligible for GLP1RA or SGLT2I according to American Diabetes Association guidelines. Interventions. GLP1RA or SGLT2I use versus no additional medication. Main Measures. Lifetime complications and weighted life-years (LYs) and quality-adjusted life-years (QALYs) across overall treatment arms and life expectancies. Key Results. The overall older adult population was predicted to experience significant health benefits from GLP1RA (+0.29 LY [95% confidence interval: 0.27, 0.31], +0.15 QALYs [0.14, 0.16]) and SGLT2I (+0.26 LY [0.24, 0.28], +0.13 QALYs [0.12, 0.14]) as compared with no added medication. However, expected benefits declined in subgroups with shorter life expectancies. Participants with <4 y of life expectancy had minimal gains of <0.05 LY and <0.03 QALYs from added medication. Accounting for injection-related disutility, GLP1RA use reduced QALYs (−0.03 QALYs [−0.04, −0.02]). Conclusions. While GLP1RA and SGLT2I have substantial health benefits for many older adults with type 2 diabetes, benefits are not clinically significant in patients with <4 y of life expectancy. Life expectancy and patient preferences are important considerations when prescribing newer diabetes medications. Highlights On average, older adults benefit significantly from SGLT2I and GLP1RA use. However, the benefits of these drugs are not clinically significant among older patients with life expectancy less than 4 y. There is potential harm in injectable GLP1RA use in the oldest categories of adults with type 2 diabetes. Heterogeneity in life expectancy and patient preferences for injectable versus oral medications are important to consider when prescribing newer diabetes medications

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Cost-effectiveness of oral semaglutide added to current antihyperglycemic treatment for type 2 diabetes

Cited by 14 publications

References 25 publications

Cost consequence analysis of adding semaglutide to treatment regimen for patients with Type II diabetes in Saudi Arabia

Cost consequence analysis of adding semaglutide to treatment regimen for patients with Type II diabetes in Saudi Arabia

Impact of BMI and comorbidities on efficacy of once‐weekly semaglutide: Post hoc analyses of the STEP 1 randomized trial

Expected Health Benefits of SGLT-2 Inhibitors and GLP-1 Receptor Agonists in Older Adults

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