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Cost Effectiveness of Once-Weekly Semaglutide Versus Once-Weekly Dulaglutide in the Treatment of Type 2 Diabetes in Canada

Author

Listed:
  • Pierre Johansen

    (Novo Nordisk A/S)

  • Jonas Håkan-Bloch

    (Novo Nordisk A/S)

  • Aiden R. Liu

    (Novo Nordisk Canada Inc.)

  • Peter G. Bech

    (Novo Nordisk Canada Inc.)

  • Sofie Persson

    (The Swedish Institute for Health Economics (IHE))

  • Lawrence A. Leiter

    (University of Toronto)

Abstract

Objective The aim of this study was to assess the cost effectiveness of semaglutide versus dulaglutide, as an add-on to metformin monotherapy, for the treatment of type 2 diabetes (T2D), from a Canadian societal perspective. Methods The Swedish Institute for Health Economics Cohort Model of T2D was used to assess the cost effectiveness of once-weekly semaglutide (0.5 or 1.0 mg) versus once-weekly dulaglutide (0.75 or 1.5 mg) over a 40-year time horizon. Using data from the SUSTAIN 7 trial, which demonstrated comparatively greater reductions in glycated hemoglobin (HbA1c), body mass index and systolic blood pressure with semaglutide, compared with dulaglutide, a deterministic base-case and scenario simulation were conducted. The robustness of the results was evaluated with probabilistic sensitivity analyses and 15 deterministic sensitivity analyses. Results The base-case analysis indicated that semaglutide is a dominant treatment option, compared with dulaglutide. Semaglutide was associated with lower total costs (Canadian dollars [CAN$]) versus dulaglutide for both low-dose (CAN$113,287 vs. CAN$113,690; cost-saving: CAN$403) and high-dose (CAN$112,983 vs. CAN$113,695; cost-saving: CAN$711) comparisons. Semaglutide resulted in increased quality-adjusted life-years (QALYs) and QALY gains, compared with dulaglutide, for both low-dose (11.10 vs. 11.07 QALYs; + 0.04 QALYs) and high-dose (11.12 vs. 11.07 QALYs; + 0.05 QALYs) comparisons. The probabilistic sensitivity analysis showed that for 66–73% of iterations, semaglutide was either dominant or was considered cost effective at a willingness-to-pay threshold of CAN$50,000. Conclusions From a Canadian societal perspective, semaglutide may be a cost-effective treatment option versus dulaglutide in patients with T2D who are inadequately controlled on metformin monotherapy.

Suggested Citation

  • Pierre Johansen & Jonas Håkan-Bloch & Aiden R. Liu & Peter G. Bech & Sofie Persson & Lawrence A. Leiter, 2019. "Cost Effectiveness of Once-Weekly Semaglutide Versus Once-Weekly Dulaglutide in the Treatment of Type 2 Diabetes in Canada," PharmacoEconomics - Open, Springer, vol. 3(4), pages 537-550, December.
    • Handle: RePEc:spr:pharmo:v:3:y:2019:i:4:d:10.1007_s41669-019-0131-6
    DOI: 10.1007/s41669-019-0131-6
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    References listed on IDEAS

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    1. Åsa Ericsson & Adam Lundqvist, 2017. "Cost Effectiveness of Insulin Degludec Plus Liraglutide (IDegLira) in a Fixed Combination for Uncontrolled Type 2 Diabetes Mellitus in Sweden," Applied Health Economics and Health Policy, Springer, vol. 15(2), pages 237-248, April.
    2. Michael Willis & Pierre Johansen & Andreas Nilsson & Christian Asseburg, 2017. "Validation of the Economic and Health Outcomes Model of Type 2 Diabetes Mellitus (ECHO-T2DM)," PharmacoEconomics, Springer, vol. 35(3), pages 375-396, March.
    3. Adam Lundqvist & Katarina Steen Carlsson & Pierre Johansen & Emelie Andersson & Michael Willis, 2014. "Validation of the IHE Cohort Model of Type 2 Diabetes and the Impact of Choice of Macrovascular Risk Equations," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-12, October.
    4. Adrian Bagust & Sophie Beale, 2005. "Modelling EuroQol health‐related utility values for diabetic complications from CODE‐2 data," Health Economics, John Wiley & Sons, Ltd., vol. 14(3), pages 217-230, March.
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