Long-Term Clinical and Economic Effects of Switching to Once-Weekly Semaglutide from Other GLP-1 RAs Among Patients with Type 2 Diabetes in China: A Modeling Projection Study.

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2024-12-16 DOI:10.1007/s12325-024-03082-7

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

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Abstract

Introduction: Previous studies, using clinical trial data, demonstrated that once-weekly (OW) semaglutide is dominant versus other glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in China. This study aims to evaluate the long-term clinical and economic effects of switching to OW semaglutide from other GLP-1 RAs among patients with type 2 diabetes mellitus (T2DM) in China.

Methods: The Institute of Health Economics Diabetes Cohort Model (IHE-DCM) was used to project life expectancy, quality-adjusted life years (QALYs), and total direct medical cost over 40 years from a Chinese healthcare system perspective. Baseline characteristics, clinical effectiveness, and the treatment dose of OW semaglutide were derived from previously real-world studies. Patients were assumed to switch to semaglutide or continue previous GLP-1 RAs for 3 years and change to intensive therapy. Drug prices were based on the median bidding price in January 2024 in China. Costs of other GLP-1 RAs were calculated on the basis of their market share in China. All costs were accounted as 2023 Chinese yuan (CNY). A discount of 5% was applied. One-way sensitivity analyses and probabilistic sensitivity analyses were used to test the robustness of the base-case result.

Results: The results show that switching to OW semaglutide from other GLP-1 RAs among patients with T2DM in China can improve life expectancy by 0.02 years and afford an additional 0.12 QALYs per patient. Meanwhile, switching to OW semaglutide is associated with decreased total lifetime direct medical costs of 4204 CNY per patient, mainly resulting from savings in microvascular costs (2214 CNY) and macrovascular costs (1228 CNY). Sensitivity analyses show the robustness of modeling projection findings.

Conclusion: Based on real-world data from China, this modeling projection study demonstrates that switching to OW semaglutide from other GLP-1 RAs can have better clinical and economic effects for patients with T2DM in China, indicating it as a dominant treatment choice.

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中国 2 型糖尿病患者从其他 GLP-1 RAs 转用每周一次塞马鲁肽的长期临床和经济效应：模型预测研究》。

简介：以往的研究利用临床试验数据表明，在中国，每周一次（OW）的塞马鲁肽与其他胰高血糖素样肽1受体激动剂（GLP-1 RA）相比具有优势。本研究旨在评估中国2型糖尿病（T2DM）患者从其他GLP-1受体激动剂改用OW型赛马鲁肽的长期临床和经济效果：采用卫生经济研究所糖尿病队列模型（IHE-DCM），从中国医疗系统的角度预测40年的预期寿命、质量调整生命年（QALY）和直接医疗总成本。基线特征、临床疗效和 OW semaglutide 的治疗剂量均来自之前的实际研究。假定患者改用塞马鲁肽或继续使用之前的 GLP-1 RAs 3 年，然后改用强化治疗。药品价格基于 2024 年 1 月中国的中位招标价格。其他 GLP-1 RAs 的成本根据其在中国的市场份额计算。所有成本均以 2023 年的人民币计算。贴现率为 5%。采用单向敏感性分析和概率敏感性分析来检验基础方案结果的稳健性：结果表明，中国的 T2DM 患者从其他 GLP-1 RAs 转用 OW semaglutide 可使预期寿命延长 0.02 年，每位患者可多获得 0.12 QALYs。同时，改用OW semaglutide可使每位患者终生直接医疗总费用减少4204元人民币，主要来自微血管费用（2214元人民币）和大血管费用（1228元人民币）的节省。敏感性分析表明了模型预测结果的稳健性：基于中国的实际数据，该模型预测研究表明，对于中国的T2DM患者而言，从其他GLP-1 RAs改用OW semaglutide可获得更好的临床和经济效果，这表明OW semaglutide是一种主要的治疗选择。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.