The Long-Term Cost-Effectiveness of Oral Semaglutide Versus Lower-Cost Liraglutide in the UK.

IF 2.6 3区医学 Q2 Medicine Diabetes Therapy Pub Date : 2025-04-01 Epub Date: 2025-02-19 DOI:10.1007/s13300-025-01691-1

Mohamed Elnaggar, Joana Nunes Mansinho, Samuel J P Malkin, Joseph Whitaker, Barnaby Hunt, Divina Glah, Martina MacLellan, Samina Ali

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Abstract

Introduction: Glucagon-like peptide-1 (GLP-1) receptor agonists represent efficacious therapies for treating type 2 diabetes. Oral semaglutide is the only orally administered GLP-1 receptor agonist currently available and has been associated with reductions in glycated hemoglobin and body weight versus once-daily injectable liraglutide after 52 weeks in the PIONEER 4 clinical trial. As lower-cost liraglutide formulations have recently been developed, the present analysis evaluated the long-term cost-effectiveness of oral semaglutide 14 mg versus liraglutide 1.8 mg at lower acquisition costs in the UK.

Methods: The published and validated PRIME Type 2 Diabetes Model was used to project clinical and cost outcomes over patient lifetimes. Baseline cohort characteristics, as well as treatment-specific changes in physiological parameters and hypoglycemia rates, were sourced from PIONEER 4. Patients were modeled to receive oral semaglutide or liraglutide until HbA1c exceeded 8.0% (64 mmol/mol), after which treatment was intensified to basal insulin. Annual disutilities associated with treatment administration were applied to capture the differential impact of a once-daily oral versus once-daily injectable medication on quality of life. Costs, expressed in 2022 pounds sterling (GBP), were calculated from a National Health Service (NHS) perspective. The acquisition cost of liraglutide was reduced by up to 50% at increments of 5% across a range of scenarios.

Results: Oral semaglutide was associated with improved quality-adjusted life expectancy of 0.18 quality-adjusted life years versus liraglutide 1.8 mg due to a reduced incidence of diabetes-related complications and a reduced treatment-administration burden. Direct, per-person complication costs were estimated to be GBP 187 lower with oral semaglutide. Oral semaglutide remained dominant or cost-effective in the majority of scenarios, even with liraglutide price reductions of 50% applied.

Conclusions: Oral semaglutide 14 mg was projected to be cost-effective versus lower-cost liraglutide 1.8 mg in the UK.

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在英国，口服西马鲁肽与低成本利拉鲁肽的长期成本-效果。

胰高血糖素样肽-1 （GLP-1）受体激动剂是治疗2型糖尿病的有效疗法。口服semaglutide是目前唯一可口服的GLP-1受体激动剂，在PIONEER 4临床试验中，与每日一次注射利拉鲁肽相比，口服semaglutide可在52周后降低糖化血红蛋白和体重。由于最近开发了低成本的利拉鲁肽制剂，本分析评估了在英国，口服西马鲁肽14mg与利拉鲁肽1.8 mg较低获取成本的长期成本效益。方法：使用已发表并经过验证的PRIME 2型糖尿病模型来预测患者生命周期内的临床和成本结果。基线队列特征，以及治疗特异性生理参数和低血糖率的变化，均来自PIONEER 4。在HbA1c超过8.0% （64 mmol/mol）之前，患者接受口服西马鲁肽或利拉鲁肽的模拟治疗，之后强化治疗至基础胰岛素。应用与治疗管理相关的年度耗损来捕捉每日一次口服药物与每日一次注射药物对生活质量的不同影响。成本以2022年英镑（GBP）表示，是从国民健康服务（NHS）的角度计算的。利拉鲁肽的购买成本在一系列情况下以5%的增量减少了高达50%。结果：口服西马鲁肽与利拉鲁肽1.8 mg相比，由于降低了糖尿病相关并发症的发生率和减轻了治疗管理负担，其质量调整寿命预期提高了0.18年。口服西马鲁肽的直接、人均并发症成本估计降低了187英镑。口服西马鲁肽在大多数情况下仍然占主导地位或具有成本效益，即使利拉鲁肽的价格降低了50%。结论：在英国，口服西马鲁肽14mg预计比低成本的利拉鲁肽1.8 mg更具成本效益。

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.