The Cost-Effectiveness of Oral Semaglutide in Spain: A Long-Term Health Economic Analysis Based on the PIONEER Clinical Trials View Full Text


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Article Info

DATE

2022-05-12

AUTHORS

Josep Franch-Nadal, Samuel J. P. Malkin, Barnaby Hunt, Virginia Martín, María Gallego Estébanez, Josep Vidal

ABSTRACT

IntroductionNovel glucagon-like peptide-1 (GLP-1) receptor agonist oral semaglutide has demonstrated greater improvements in glycated hemoglobin (HbA1c) and body weight versus oral medications empagliflozin and sitagliptin, and injectable GLP-1 analog liraglutide, in the PIONEER clinical trial program. Based on these data, the present analysis aimed to evaluate the long-term cost-effectiveness of oral semaglutide versus empagliflozin, sitagliptin and liraglutide in Spain.MethodsOutcomes were projected over patients’ lifetimes using the IQVIA CORE Diabetes Model (v9.0), discounted at 3.0% annually. Cohort characteristics and treatment effects were sourced from PIONEER 2 and 4 for the comparisons of oral semaglutide 14 mg versus empagliflozin 25 mg and liraglutide 1.8 mg, respectively, and PIONEER 3 for oral semaglutide 7 and 14 mg versus sitagliptin 100 mg. Costs were accounted from a healthcare payer perspective in 2020 euros (EUR). Patients were assumed to receive initial therapies until HbA1c exceeded 7.5% and then treatment-intensified to basal insulin.ResultsOral semaglutide 14 mg was associated with improvements in quality-adjusted life expectancy of 0.13, 0.19 and 0.06 quality-adjusted life years (QALYs) versus empagliflozin 25 mg, sitagliptin 100 mg and liraglutide 1.8 mg, respectively, with direct costs EUR 168 higher versus empagliflozin and EUR 236 and 1415 lower versus sitagliptin and liraglutide, respectively. Oral semaglutide 14 mg was associated with an incremental cost-effectiveness ratio (ICER) of EUR 1339 per QALY gained versus empagliflozin and was considered dominant (clinically superior and cost saving) versus sitagliptin and liraglutide. Additional analyses demonstrated that oral semaglutide 7 mg was associated with improvements of 0.11 QALYs and increased costs of EUR 226 versus sitagliptin and was therefore associated with an ICER of EUR 2011 per QALY gained.ConclusionOral semaglutide 14 mg was dominant versus sitagliptin and liraglutide, and cost-effective versus empagliflozin, for the treatment of type 2 diabetes in Spain. More... »

PAGES

3180-3198

References to SciGraph publications

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  • 2020-08-29. Evaluation of the Long-Term Cost-Effectiveness of Once-Weekly Semaglutide Versus Dulaglutide and Sitagliptin in the Spanish Setting in ADVANCES IN THERAPY
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1007/s12325-022-02156-8

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    https://www.ncbi.nlm.nih.gov/pubmed/35553372


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    29 schema:description IntroductionNovel glucagon-like peptide-1 (GLP-1) receptor agonist oral semaglutide has demonstrated greater improvements in glycated hemoglobin (HbA1c) and body weight versus oral medications empagliflozin and sitagliptin, and injectable GLP-1 analog liraglutide, in the PIONEER clinical trial program. Based on these data, the present analysis aimed to evaluate the long-term cost-effectiveness of oral semaglutide versus empagliflozin, sitagliptin and liraglutide in Spain.MethodsOutcomes were projected over patients’ lifetimes using the IQVIA CORE Diabetes Model (v9.0), discounted at 3.0% annually. Cohort characteristics and treatment effects were sourced from PIONEER 2 and 4 for the comparisons of oral semaglutide 14 mg versus empagliflozin 25 mg and liraglutide 1.8 mg, respectively, and PIONEER 3 for oral semaglutide 7 and 14 mg versus sitagliptin 100 mg. Costs were accounted from a healthcare payer perspective in 2020 euros (EUR). Patients were assumed to receive initial therapies until HbA1c exceeded 7.5% and then treatment-intensified to basal insulin.ResultsOral semaglutide 14 mg was associated with improvements in quality-adjusted life expectancy of 0.13, 0.19 and 0.06 quality-adjusted life years (QALYs) versus empagliflozin 25 mg, sitagliptin 100 mg and liraglutide 1.8 mg, respectively, with direct costs EUR 168 higher versus empagliflozin and EUR 236 and 1415 lower versus sitagliptin and liraglutide, respectively. Oral semaglutide 14 mg was associated with an incremental cost-effectiveness ratio (ICER) of EUR 1339 per QALY gained versus empagliflozin and was considered dominant (clinically superior and cost saving) versus sitagliptin and liraglutide. Additional analyses demonstrated that oral semaglutide 7 mg was associated with improvements of 0.11 QALYs and increased costs of EUR 226 versus sitagliptin and was therefore associated with an ICER of EUR 2011 per QALY gained.ConclusionOral semaglutide 14 mg was dominant versus sitagliptin and liraglutide, and cost-effective versus empagliflozin, for the treatment of type 2 diabetes in Spain.
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    35 schema:keywords Additional analyses
    36 GLP-1 analogue liraglutide
    37 IQVIA CORE
    38 MethodsOutcomes
    39 PIONEER 2
    40 PIONEER clinical trial program
    41 Pioneer 3
    42 Spain
    43 analogue liraglutide
    44 analysis
    45 body weight
    46 characteristics
    47 clinical trial program
    48 clinical trials
    49 cohort characteristics
    50 comparison
    51 core
    52 cost
    53 cost of euro
    54 cost-effectiveness ratio
    55 data
    56 diabetes
    57 economic analysis
    58 effect
    59 empagliflozin
    60 empagliflozin 25
    61 euro
    62 expectancy
    63 greater improvement
    64 health economic analysis
    65 healthcare payer perspective
    66 hemoglobin
    67 improvement
    68 incremental cost-effectiveness ratio
    69 initial therapy
    70 insulin
    71 life expectancy
    72 life years
    73 lifetime
    74 liraglutide
    75 model
    76 oral semaglutide
    77 oral semaglutide 14
    78 patients
    79 payer perspective
    80 perspective
    81 pioneer clinical trials
    82 present analysis
    83 program
    84 quality-adjusted life expectancy
    85 quality-adjusted life years
    86 ratio
    87 semaglutide
    88 sitagliptin
    89 sitagliptin 100
    90 therapy
    91 treatment
    92 treatment effects
    93 trial program
    94 trials
    95 type 2 diabetes
    96 weight
    97 years
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