Budget Impact Analysis of GLP-1 Receptor Agonists for Type 2 Diabetes Management in India
Author(s)
Lalit Thakur, MHA, Ritesh Bisen, MBA, Divya Puthran, MSc.
Amethys Insights Pvt Ltd, Mumbai, India.
Amethys Insights Pvt Ltd, Mumbai, India.
OBJECTIVES: India's type 2 diabetes (T2D) epidemic drives demand for advanced GLP-1 RAs- (Semaglutide, Dulaglutide, Tirzepatide), though their high costs challenge healthcare budgets. This study evaluates India's five-year (2025-2029) budget impact from a payer perspective, exploring cost-containment strategies while addressing data limitations through modeled assumptions.
METHODS: A Microsoft Excel-based budget impact model (2025-2029) assessed the introduction of GLP-1 RAs (semaglutide, dulaglutide, tirzepatide) for adults (≥18 years) with T2D in India. It included demographic projections, market share estimates, and treatment costs from public sources. Outcomes included total and per-patient per year and month costs (PPPY, PPPM). One-way sensitivity analysis evaluated key uncertainties, while scenario analyses examined the impact of semaglutide patent expiry, potential tirzepatide price reductions, and alternative market share distributions.
RESULTS: The study modeled a hypothetical cohort of 100,000 T2D patients, with the eligible population increasing from 3,657 (2025) to 5,044 (2029). Cumulative five-year costs reached ₹3.44 billion for semaglutide, ₹1.56 billion for dulaglutide, and ₹15.9 million for tirzepatide. Average PPPY costs were ₹231,265 ((Semaglutide), ₹234,896 (Dulaglutide), and ₹331,193 (Tirzepatide), with annual costs increased driven by population growth and update. Sensitivity analysis identified drug costs and market shares as primary budget drivers. Scenario analysis suggested semaglutide's PPPY cost could decrease by 20% (to ₹194,515) following patent expiry, while tirzepatide's cost might reduce to ₹310,613 with market-driven price adjustments. The study's limitations included reliance on projected rather than observed market data and necessary assumptions about treatment adherence and price elasticity.
CONCLUSIONS: GLP-1 RAs pose a substantial budget impact in the Indian setting and, these projections require cautious interpretation given data limitations. Modeled scenarios suggest patent expiry discounts and managed uptake—may improve affordability. Actual implementation should be guided by real-world evidence as adoption progresses.
METHODS: A Microsoft Excel-based budget impact model (2025-2029) assessed the introduction of GLP-1 RAs (semaglutide, dulaglutide, tirzepatide) for adults (≥18 years) with T2D in India. It included demographic projections, market share estimates, and treatment costs from public sources. Outcomes included total and per-patient per year and month costs (PPPY, PPPM). One-way sensitivity analysis evaluated key uncertainties, while scenario analyses examined the impact of semaglutide patent expiry, potential tirzepatide price reductions, and alternative market share distributions.
RESULTS: The study modeled a hypothetical cohort of 100,000 T2D patients, with the eligible population increasing from 3,657 (2025) to 5,044 (2029). Cumulative five-year costs reached ₹3.44 billion for semaglutide, ₹1.56 billion for dulaglutide, and ₹15.9 million for tirzepatide. Average PPPY costs were ₹231,265 ((Semaglutide), ₹234,896 (Dulaglutide), and ₹331,193 (Tirzepatide), with annual costs increased driven by population growth and update. Sensitivity analysis identified drug costs and market shares as primary budget drivers. Scenario analysis suggested semaglutide's PPPY cost could decrease by 20% (to ₹194,515) following patent expiry, while tirzepatide's cost might reduce to ₹310,613 with market-driven price adjustments. The study's limitations included reliance on projected rather than observed market data and necessary assumptions about treatment adherence and price elasticity.
CONCLUSIONS: GLP-1 RAs pose a substantial budget impact in the Indian setting and, these projections require cautious interpretation given data limitations. Modeled scenarios suggest patent expiry discounts and managed uptake—may improve affordability. Actual implementation should be guided by real-world evidence as adoption progresses.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE85
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)