Cost–effectiveness of empagliflozin versus weekly semaglutide as add-on therapy for Type 2 diabetes

• Published in: Journal of comparative effectiveness research Vol. 10; no. 15; pp. 1133 - 1141
• Main Authors: Zupa, Margaret F, Codario, Ronald A, Smith, Kenneth J
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01-10-2021
• Subjects: Aged; Benzhydryl Compounds; Cost-Benefit Analysis; cost–effectiveness analysis; diabetes; Diabetes Mellitus, Type 2 - drug therapy; GLP-1 receptor agonist; Glucagon-Like Peptides; Glucosides; Humans; Hypoglycemic Agents - therapeutic use; pharmacoeconomics; SGLT2 inhibitor; GLP-1 receptor agonist; cost–effectiveness analysis; pharmacoeconomics; SGLT2 inhibitor; diabetes
• ISSN: 2042-6305; 2042-6313; 2042-6313
• DOI: 10.2217/cer-2021-0016

Perform a cost–effectiveness analysis of addition of subcutaneous semaglutide versus empagliflozin to usual treatment for patients with Type 2 diabetes and cardiovascular disease in US setting.
A Markov decision model estimated the impact of each strategy using cardiovascular complication rates based on EMPA-REG and SUSTAIN-6 trials. Modeled cohorts were followed for 3 years at 1-month intervals beginning at age 66.
Compared with empagliflozin, semaglutide resulted in cost of US$19,964 per quality-adjusted life-year gained. In one-way sensitivity analysis, only semaglutide cost >US$36.25/day (base case US$18.04) resulted in empagliflozin being preferred at a willingness-to-pay threshold of US$50,000/quality-adjusted life-year gained.
For patients with Type 2 diabetes and cardiovascular disease, semaglutide is likely more cost-effective than empagliflozin added to usual treatment.