Oral Semaglutide Associated With Reduced Costs, Improved QALYs for Type 2 Diabetes Patients

Oral semaglutide, the first tablet formulation glucagon-like peptide-1 receptor agonist (GLP-1RA) for the treatment of adult patients with type 2 diabetes is associated with lower costs and improved quality adjusted life years (QALYs), according to a study presented in AMCP eLearning Days.

Sarah N Ali, MPH, fellow, health economics and outcomes research, Novo Nordisk Inc, Plainsboro, NJ, and colleagues, conducted a study to estimate the incremental cost utility ratio of oral semaglutide vs subcutaneous GLP-1RAs in patients presenting with type 2 diabetes who are already inadequately controlled on 1 or 2 oral anti-diabetic drugs. Oral semaglutide dosage was 14mg once a day.

The study used a state-transition model with competing risks—including nonfatal (macrovascular) and fatal (type 2 diabetes-related or all cause) events—to estimate lifetime costs and outcomes. The baseline cohort characteristics were derived from the 52-week PIONEER 4 trial.

Treatment efficacy estimates were obtained via network meta-analysis, indirectly comparing oral semaglutide to the GLP-1RAs, explained the researchers. Event and disease management costs (including adverse event costs) to a health care payer and utilities were obtained from the published literature. Costs and outcomes were discounted at 3% annually and reflect 2019 USD

According to the results, oral semaglutide dominated dulaglutide and liraglutide in the base-case, (-$1,656 and -$5,363), with similar but higher life years (0.008 and 0.013 increase) and quality adjusted life years (0.004 and 0.007 increase).

After uncertainty and sensitivity tests, results remained unchanged. Total lifetime QALYs estimated were similar for oral semaglutide and its subcutaneous formulation, 12.975 vs 12.986 respectively. A net savings of $1769 per patients was recorded.

Results of this study show promising cost reduction and improved QALYs for patients treated with oral semaglutide. —Edan Stanley