Assessing Cost-Effectiveness in Diabetes Management: A US Healthcare Payer’s Perspective on 15MG Tirzepatide Versus 1MG Semaglutide

OBJECTIVES: This study aims to evaluate the cost-effectiveness of 15mg tirzepatide compared to 1mg semaglutide in managing type-2 diabetes over 40 weeks, based on the SURPASS-2 trial, from a US healthcare payer’s perspective.

METHODS: The study utilizes a decision tree model to analyze data from the SURPASS-2 trial over 40 weeks, focusing on A1c reduction and weight loss. This model includes real-world clinical data, evaluating treatment efficacy, side effects, and patient adherence. Cost calculations consider direct medical costs, including the medications’ wholesale acquisition cost and side effects treatment. The analysis used the Incremental Cost-Effectiveness Ratio (ICER) as the primary endpoint.

RESULTS: Over 40 weeks, treatment with tirzepatide 15 mg was estimated to be more costly than semaglutide 1 mg, with incremental costs of $2,568. The ICER for tirzepatide 15 mg compared with semaglutide 1 mg, based on an incremental A1c reduction of 0.45% from SURPASS-2, was $5,707 per 1% reduction in A1c and was $467.27 per 1 kg body weight loss based on an incremental bodyweight loss of 5.5 kg.

CONCLUSIONS: In conclusion, tirzepatide 15mg emerges as a promising therapy for T2D, particularly effective in obese patients. This study indicates that a weekly injection of 15mg tirzepatide is a cost-effective alternative to 1mg semaglutide for type-2 diabetes management from the perspective of US healthcare payers. The ICER for tirzepatide falls below the commonly accepted willingness-to-pay threshold of $50,000-$100,000 in the US. Despite its higher upfront costs, the significant benefits in controlling blood sugar and weight loss suggest that tirzepatide is a valuable treatment for overweight or obese patients with poorly controlled diabetes. Tirzepatide’s role in healthcare should be considered for its short-term and long-term impacts on healthcare budgets and patient outcomes.