The Long-Term Cost-Effectiveness of Tirzepatide 5 mg versus Dulaglutide 0.75 mg for the Treatment of People with Type 2 Diabetes in Japan.

IF 3.8 3区医学 Q2 Medicine Diabetes Therapy Pub Date : 2025-03-01 Epub Date: 2024-12-21 DOI:10.1007/s13300-024-01675-7

Toshihiko Aranishi, Ataru Igarashi, Kazuo Hara, Beatrice Osumili, Zhihong Cai, Aska Mizogaki, Manaka Sato, Masakazu Takeuchi, Alice Minghetti, Barnaby Hunt, Takashi Kadowaki

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Abstract

Introduction: This analysis aimed to evaluate the long-term cost-effectiveness of tirzepatide 5 mg versus dulaglutide 0.75 mg (both administered once weekly) in people not achieving glycemic control on metformin, based on the results of the head-to-head SURPASS J-mono trial from a Japanese healthcare payer perspective.

Methods: A cost-utility analysis was performed over a 50-year time horizon using an implementation of the UKPDS Outcomes Model 2 developed in Microsoft Excel. Baseline cohort characteristics, treatment effects and adverse event rates were sourced from the SURPASS J-mono trial. Simulated patients were assumed to receive either tirzepatide 5 mg or dulaglutide 0.75 mg until HbA1c exceeded 8.0%, at which point treatment was discontinued and basal insulin was initiated. Direct costs were derived from the Japan Medical Data Center claims database. Future costs and clinical benefits were discounted at 2% annually.

Results: In this cost-utility modeling analysis, tirzepatide 5 mg was associated with lower diabetes-related complication rates, improved life expectancy, improved quality-adjusted life expectancy and higher direct costs versus dulaglutide 0.75 mg. This resulted in an incremental cost-effectiveness ratio (ICER) of JPY (Japanese yen) 1,302,240 per quality-adjusted life year (QALY) gained for tirzepatide 5 mg versus dulaglutide 0.75 mg (JPY 140 = USD 1). Tirzepatide remained cost-effective versus dulaglutide over a range of sensitivity analyses.

Conclusions: In this analysis, tirzepatide 5 mg was associated with an ICER below the commonly quoted willingness-to-pay threshold of JPY 5,000,000 per QALY gained, suggesting that tirzepatide is a cost-effective treatment option for adult patients with type 2 diabetes mellitus, compared with dulaglutide 0.75 mg.

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5 mg替西帕肽与0.75 mg杜拉鲁肽在日本治疗2型糖尿病患者的长期成本效益

本分析旨在评估5 mg替西帕肽与0.75 mg杜拉鲁肽（均为每周一次）在二甲双胍未达到血糖控制的患者中的长期成本效益，基于日本医疗保健支付者视角的头对头试验的结果。方法：采用Microsoft Excel开发的UKPDS结局模型2，进行了50年时间范围内的成本效用分析。基线队列特征、治疗效果和不良事件发生率来源于exceed J-mono试验。假设模拟患者接受替西帕肽5 mg或杜拉鲁肽0.75 mg，直到HbA1c超过8.0%，此时停止治疗并开始基础胰岛素治疗。直接费用来源于日本医疗数据中心索赔数据库。未来成本和临床效益每年折现2%。结果：在这个成本效用模型分析中，与0.75 mg的替西肽相比，5mg的替西肽与较低的糖尿病相关并发症发生率、改善的预期寿命、改善的质量调整预期寿命和更高的直接成本相关。结果表明，替西帕肽5 mg与杜拉鲁肽0.75 mg（140日元= 1美元）相比，每个质量调整生命年（QALY）的增量成本-效果比（ICER）为1,302,240日元。在一系列敏感性分析中，替西帕肽与杜拉鲁肽仍然具有成本效益。结论：在本分析中，替西帕肽5mg与ICER相关，低于通常引用的每QALY获得500万日元的支付意愿阈值，这表明与dulaglutide 0.75 mg相比，替西帕肽是成人2型糖尿病患者的一种经济有效的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes 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 areas of diabetes. 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. Diabetes 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.