The Cost-Effectiveness of Subcutaneous Semaglutide Versus Empagliflozin in Type 2 Diabetes Uncontrolled on Metformin Alone in Denmark

Ehlers, Lars Holger; Lamotte, M; Ramos, Mafalda; Sandgaard, Susanne; Holmgaard, Pia; Kristensen, Malene M; Ejskjær, Niels

doi:10.1007/s13300-022-01221-3

Cited by 9 publications

(28 citation statements)

References 32 publications

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“…However, decisionmakers should also look at long-term cost-effectiveness in prioritizing and decision-making [11]. Our study supports the short-term estimates from Ehlers 2022 [12], but cannot address long-term cost-effectiveness, which remains to be explored in further studies.…”

Section: Comparison With Other Studiesmentioning

confidence: 60%

“…Few, if any, population-based studies have directly compared observed healthcare costs in new users of empagliflozin vs. new users of a GLP-1RA in a nationwide setting. A recent Danish simulation study used pooled data from clinical trials to evaluate the cost-effectiveness of subcutaneous semaglutide vs. empagliflozin among patients with type 2 diabetes treated with metformin who required treatment intensification [ 12 ]. The study found that the difference in costs between the two groups was mainly driven by different prices of the GLP-1RA and the SGLT2i.…”

Section: Discussionmentioning

confidence: 99%

“…The Danish [12] and UK [23] cost-effectiveness analyses were based on the same metaanalysis and indirect comparison of clinical trial data and both had a 50-year time horizon. The main difference was the duration of therapy for once-weekly subcutaneous semaglutide or empagliflozin [12]. In the Ehlers et al analysis [12], patients continued the GLP-1RA or SGLT2i plus metformin along with basal insulin at time of treatment intensification with basal insulin.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…The main difference was the duration of therapy for once-weekly subcutaneous semaglutide or empagliflozin [12]. In the Ehlers et al analysis [12], patients continued the GLP-1RA or SGLT2i plus metformin along with basal insulin at time of treatment intensification with basal insulin.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…Thus, they should not be the only economic input used to assess drug costs [ 11 ]. Because direct comparisons of total healthcare costs between an SGLT2i and a GLP-1RA are very scarce [ 12 ], we undertook a comparative cohort study in a routine clinical care setting in Denmark. Our aim was to assess direct healthcare resource utilization, including all hospital care, primary care, and prescription medication costs associated with initiation of empagliflozin versus GLP-1RAs.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare Resource Utilization and Costs for Empagliflozin Versus Glucagon-Like Peptide-1 Receptor Agonists in Routine Clinical Care in Denmark

et al. 2022

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Introduction:The sodium-glucose cotransporter 2 inhibitor (SGLT2i) empagliflozin has shown reductions in major adverse cardiac events similar to glucagon-like peptide-1 receptor agonists (GLP-1RAs). However, evidence is limited about how these therapies compare regarding overall healthcare resource utilization and costs in routine clinical care. Methods: We conducted a comparative cohort study based on linked prospective healthcare databases for the entire population of Denmark during 2015-2018. We included 13,747 new

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Section: Comparison With Other Studiesmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Comparison With Other Studiesmentioning

confidence: 99%

Section: Comparison With Other Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Healthcare Resource Utilization and Costs for Empagliflozin Versus Glucagon-Like Peptide-1 Receptor Agonists in Routine Clinical Care in Denmark

et al. 2022

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Multinational cost‐effectiveness analysis of empagliflozin for heart failure patients with ejection fraction >40%

Kolovos,

Bellanca,

Groyer

et al. 2023

ESC Heart Failure

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AimsHeart failure is a chronic progressive condition, with considerable burden on patients' quality of life and economic burden for the healthcare systems. Before the approval of empagliflozin, there were no proven effective treatments for patients with heart failure with left ventricular ejection fraction (HF LVEF) > 40%. The aim of this study was to evaluate the cost‐effectiveness of empagliflozin + standard of care (SoC) compared with SoC alone for patients with HF LVEF > 40%, from the perspective of the healthcare systems of the United Kingdom (UK), Spain, and France, and to quantify the healthcare costs for these patients.Methods and resultsA lifetime Markov cohort state‐transition model was developed based on discrete health states defined by Kansas City Cardiomyopathy Questionnaire‐Clinical Summary Score quartiles to track disease severity. Model inputs relied primarily on the EMPEROR‐Preserved trial data or obtained from published literature or country‐specific databases, as well as local guidelines for the requirements for the conduct of the economic evaluation of healthcare technologies. The total lifetime cost of receiving SoC per patient was £10 092, €15 765, and €14 958 in the UK, Spain, and France, respectively, which increased by £1407, €1148, and €1485, respectively, with the addition of empagliflozin to the SoC. Empagliflozin + SoC was associated with significantly reduced number of hospitalization for HF or cardiovascular death compared with SoC alone, which was a key driver offsetting its drug acquisition costs. The incremental cost‐effectiveness ratio per quality‐adjusted life year (QALY) gained was consistently favourable at £14 851, €11 706, and €15 447 in the UK, Spain, and France, respectively. Scenario analysis using the New York Heart Association functional class showed similar results. Probabilistic sensitivity analyses showed more than 50% probability for cost‐effectiveness for a willingness‐to‐pay (WTP) threshold of £/€20 000/QALY for the three countries.ConclusionsEmpagliflozin was found to be the first targeted treatment option that is clinically effective and cost‐effective for patients with HF LVEF > 40%. Prescribing empagliflozin with SoC to patients with HF LVEF > 40% is expected to improve clinical outcomes and patients' quality of life and substantially below accepted WTP threshold for the healthcare systems in the UK, Spain, and France.

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Cost-Effectiveness of Newer Antidiabetic Drugs as Second-Line Treatment for Type 2 Diabetes: A Systematic Review

Zhu

Zhou

et al. 2023

Adv Ther

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Introduction Evidence from cardiovascular outcome trials (CVOTs) for newer antidiabetic drugs is increasingly influencing revised recommendations for second-line therapy in type 2 diabetes (T2D). This systematic review aimed to compare the cost-effectiveness of newer antidiabetic drugs specified as sodium-glucose cotransporter 2 inhibitor (SGLT2i), glucagon-like peptide 1 receptor agonist (GLP-1RA), and dipeptidyl peptidase 4 inhibitor (DPP-4i) for T2D in a second-line setting. Methods A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, and all relevant published studies were searched comprehensively in electronic databases, including PubMed, Embase, Web of Science, and International Health Technology Assessment database published from April 2023. The quality of the included studies was evaluated using Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 reporting checklists. Results We included 28 studies that met the inclusion criteria. Overall reporting of the identified studies largely met CHEERS 2022 recommendations. The CORE and Cardiff models were the most frequently utilized for pharmacoeconomic evaluation in T2D. Four studies consistently discovered that SGLT2i was more cost-effective than GLP-1RA in T2D who were not adequately controlled by metformin monotherapy. Four studies compared GLP-1RA with DPP-4i, sufonylurea (SU), or insulin. Except for one that demonstrated SU was cost-effective, all were GLP-1RA. Five studies revealed that SGLT2i was more cost-effective than DPP-4i or SU. Eleven studies indicated that DPP-4i was more cost-effective than traditional antidiabetic drugs. Four additional studies explored the cost-effectiveness of various antidiabetic drugs as second-line options, indicating that SU, SGLT2i, or meglitinides were more economically advantageous. The most common driven factors were the cost of new antidiabetic drugs. Conclusion Newer antidiabetic drugs as second line are the cost-effective option for T2D from the cost-effectiveness perspective, especially SGLT2i. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02612-z.

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The Cost-Effectiveness of Subcutaneous Semaglutide Versus Empagliflozin in Type 2 Diabetes Uncontrolled on Metformin Alone in Denmark

Cited by 9 publications

References 32 publications

Healthcare Resource Utilization and Costs for Empagliflozin Versus Glucagon-Like Peptide-1 Receptor Agonists in Routine Clinical Care in Denmark

Healthcare Resource Utilization and Costs for Empagliflozin Versus Glucagon-Like Peptide-1 Receptor Agonists in Routine Clinical Care in Denmark

Multinational cost‐effectiveness analysis of empagliflozin for heart failure patients with ejection fraction >40%

Cost-Effectiveness of Newer Antidiabetic Drugs as Second-Line Treatment for Type 2 Diabetes: A Systematic Review

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