Presentation (CTI)

OBJECTIVES: Colombian healthcare system is undergoing substantial structural transformation, facing increasing pressure on financial sustainability and a growing need for evidence supporting efficient resource allocation. In this context, short-term economic and clinical outcomes are critical to inform coverage, positioning in clinical guidelines, and reimbursement decisions. The aim was to compare short-term costs and health outcomes associated with semaglutide and tirzepatide in patients with type 2 diabetes mellitus (T2D) from the perspective of the Colombian healthcare system.
METHODS: A short-term comparative economic evaluation was conducted for commercially available formulations of semaglutide and tirzepatide in Colombia for patients with T2D. Outcomes included: average monthly cost, annual cost per patient, cost per 1% reduction in glycated hemoglobin (HbA1c), cost per kilogram of weight reduction, and costs associated with avoided major clinical events (myocardial infarction, stroke, and chronic kidney disease). Clinical efficacy and outcomes data were sourced from the SUSTAIN, SURPASS, SOUL, and FLOW trials. Cost inputs were obtained from national tariff manuals, public market prices, and published literature. Deterministic sensitivity analyses were performed.
RESULTS: Compared with tirzepatide 5 mg, injectable semaglutide 1 mg was associated with substantially lower short-term costs, with an 83% lower annual cost per patient, a 63% lower cost per 1% HbA1c reduction, and a 56% lower cost per kilogram of weight reduced. When compared with tirzepatide 15 mg, these differences increased to 177%, 117%, and 61%, respectively. The assessment of avoided major clinical events resulted in average cost offsets of USD 580 per patient. Findings were consistent across sensitivity analyses.
CONCLUSIONS: Within the context of financial sustainability challenges in Colombia, semaglutide demonstrated more favorable short-term economic value compared with tirzepatide. These findings provide actionable evidence to inform HTA processes, reimbursement decisions, and evidence-based guideline positioning in Colombia and similar middle-income settings.