Tirzepatide in the Treatment of Diabetes: A Systematic Overeview of Economic Evaluations

OBJECTIVES: This systematic review aimed to overview the body of evidence on cost-effectiveness of tirzepatide for managing diabetes type 2 in adults.

METHODS: We have conducted a systematic literature review (as per PRISMA guidelines). Studies written in English, cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) on tirzepatide for the treatment of diabetes type 2 and comparisons of this regimen against other antihyperglycemic agents, were considered for inclusion. A comprehensive search [(diabetes) AND (tirezepatide) AND (econom* OR cost*)] was conducted across PubMed/Medline on 25^th June 2024. Data was manually extracted.

RESULTS: The literature search yielded 36 records in total. Following screening, 4 CEAs (United States), and 1 CUA (China) were included for further analysis. Studies were conducted predominantly from the healthcare payer’s perspective. All studies used semaglutide as the comparator, and predominantly concluded towards tirzepatide being more cost-effective than semaglutide. Nikitin et al. also provided CEAs for: i) tirzepatide+background therapy (BT=metformin ± sulfonylureas or thiazolidinediones) vs empagliflozin+BT, and ii) tirezepatide+BT vs BT. The ICERs yielded were: i) US$101,000/QALY / US$160,000/LYG, and ii) US$58,000/QALY / US$44,000/LYG, respectively.

CONCLUSIONS: Although the body of literature on the present topic is still quite scarce, tirzepatide seems to be more cost-effective both in comparison to semaglutide and BT for the treatment of type 2 diabetes. However, future research should focus on resolving uncertainties in economic evaluations and broaden the scope to include MACE benefits, renal benefits, and prevention/management of diabetes-related complications into calculations when yielding ICER.