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Introduction <p>This study aimed to evaluate the long- and short-term cost-effectiveness of once-weekly semaglutide versus dulaglutide for treating patients with type 2 diabetes uncontrolled with metformin after the renewal of China’s national reimbursement drug list.</p> Methods <p>This analysis was conducted using the Institute of Health Economics Diabetes Cohort Model (IHE-DCM) to evaluate the long-term health and economic outcomes of semaglutide 0.5&#xa0;mg, 1.0&#xa0;mg, and dulaglutide 1.5&#xa0;mg. It was performed from the perspective of the Chinese healthcare systems over a 40-year time horizon, with an annual discount rate of 5%. Baseline cohort characteristics and treatment effects were sourced from the head-to-head clinical trial SUSTAIN 7, which compared the efficacy and safety of semaglutide and dulaglutide. The analysis included direct medical costs regarding antidiabetic treatment and complication treatment. The long-term cost-effectiveness analysis used quality-adjusted life years (QALYs) as the primary health outcome. The robustness of the results was evaluated through one-way sensitivity analyses and probabilistic sensitivity analyses. The short-term cost-effectiveness analysis, focusing on the proportion of patients achieving clinical targets as the health outcome, compared the control costs of successfully treating a patient to meet clinical treatment goals between semaglutide 0.5&#xa0;mg, 1.0&#xa0;mg, and dulaglutide 1.5&#xa0;mg over a 40-week study period.</p> Results <p>Compared with dulaglutide 1.5&#xa0;mg, once-weekly semaglutide 0.5&#xa0;mg demonstrated an improvement of 0.08 QALYs and a reduction in total direct medical costs of 5476 Chinese yuan (CNY); Once-weekly semaglutide 1.0&#xa0;mg showed an increase of 0.19 QALYs, and a decrease in total direct medical costs of 6711 CNY. Sensitivity analyses confirmed the robustness of these results. In the short-term cost-of-control study, once-weekly semaglutide 0.5&#xa0;mg demonstrated lower treatment costs for all targets: the costs of control for dulaglutide 1.5&#xa0;mg were 1.2–2.1 times as much as that of semaglutide 0.5&#xa0;mg once weekly. Semaglutide 1.0&#xa0;mg achieved similar treatment costs for the good glycemic control goal (HbA<sub>1c</sub> &lt; 7%) to dulaglutide 1.5&#xa0;mg. However, when looking at tight glycemic control, weight management targets, and composite targets relating to weight loss, once-weekly semaglutide 1.0&#xa0;mg showed lower treatment costs compared to dulaglutide 1.5&#xa0;mg to bring at least one patient to achieve these targets.</p> Conclusions <p>Compared to dulaglutide 1.5&#xa0;mg, once-weekly semaglutide remains cost-effective for treating type 2 diabetes uncontrolled on metformin in China under the new negotiation price. However, limitations exist, including the reliance on SUSTAIN-7 data and the lack of specific utility data for the Chinese population.</p>

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Long- and Short-Term Cost-Effectiveness of Once-Weekly Semaglutide versus Dulaglutide for the Treatment of Type 2 Diabetes in China: A Hypothetical Modeling Exercise

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月19日

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  • Ying Hu,
  • Huimin Zou,
  • Yang Shen,
  • Qi Ni,
  • Yijun Li,
  • Hao Zhang,
  • Xianwen Chen,
  • Carolina Oi Lam Ung,
  • Hao Hu,
  • Yiming Mu

摘要

Introduction

This study aimed to evaluate the long- and short-term cost-effectiveness of once-weekly semaglutide versus dulaglutide for treating patients with type 2 diabetes uncontrolled with metformin after the renewal of China’s national reimbursement drug list.

Methods

This analysis was conducted using the Institute of Health Economics Diabetes Cohort Model (IHE-DCM) to evaluate the long-term health and economic outcomes of semaglutide 0.5 mg, 1.0 mg, and dulaglutide 1.5 mg. It was performed from the perspective of the Chinese healthcare systems over a 40-year time horizon, with an annual discount rate of 5%. Baseline cohort characteristics and treatment effects were sourced from the head-to-head clinical trial SUSTAIN 7, which compared the efficacy and safety of semaglutide and dulaglutide. The analysis included direct medical costs regarding antidiabetic treatment and complication treatment. The long-term cost-effectiveness analysis used quality-adjusted life years (QALYs) as the primary health outcome. The robustness of the results was evaluated through one-way sensitivity analyses and probabilistic sensitivity analyses. The short-term cost-effectiveness analysis, focusing on the proportion of patients achieving clinical targets as the health outcome, compared the control costs of successfully treating a patient to meet clinical treatment goals between semaglutide 0.5 mg, 1.0 mg, and dulaglutide 1.5 mg over a 40-week study period.

Results

Compared with dulaglutide 1.5 mg, once-weekly semaglutide 0.5 mg demonstrated an improvement of 0.08 QALYs and a reduction in total direct medical costs of 5476 Chinese yuan (CNY); Once-weekly semaglutide 1.0 mg showed an increase of 0.19 QALYs, and a decrease in total direct medical costs of 6711 CNY. Sensitivity analyses confirmed the robustness of these results. In the short-term cost-of-control study, once-weekly semaglutide 0.5 mg demonstrated lower treatment costs for all targets: the costs of control for dulaglutide 1.5 mg were 1.2–2.1 times as much as that of semaglutide 0.5 mg once weekly. Semaglutide 1.0 mg achieved similar treatment costs for the good glycemic control goal (HbA1c < 7%) to dulaglutide 1.5 mg. However, when looking at tight glycemic control, weight management targets, and composite targets relating to weight loss, once-weekly semaglutide 1.0 mg showed lower treatment costs compared to dulaglutide 1.5 mg to bring at least one patient to achieve these targets.

Conclusions

Compared to dulaglutide 1.5 mg, once-weekly semaglutide remains cost-effective for treating type 2 diabetes uncontrolled on metformin in China under the new negotiation price. However, limitations exist, including the reliance on SUSTAIN-7 data and the lack of specific utility data for the Chinese population.