Cost-Effectiveness Analysis of Oral Semaglutide As a Third-Line Treatment for Patients With Type 2 Diabetes Mellitus
Author(s)
Ruen Yi (Ella) Chen, MS1, Audrey Lee, MS1, Jonathan Wu, MS1, Elise Chia Hui Tan, MHA, MS, PhD2.
1Novo Nordisk Taiwan, Taipei City, Taiwan, 2China Medical University, Taiwan, Taichung, Taiwan.
1Novo Nordisk Taiwan, Taipei City, Taiwan, 2China Medical University, Taiwan, Taichung, Taiwan.
Presentation Documents
OBJECTIVES: Oral glucagon-like peptide-1 receptor agonist (GLP-1 RA) effectively controls blood sugar, facilitates weight loss, and provides cardiovascular protection for type 2 diabetes mellitus (T2DM). This study evaluated the cost-effectiveness of oral semaglutide from the healthcare payer’s perspective in Taiwan.
METHODS: This study targeted T2DM patients who received metformin or sulfonylurea combined with DPP-4 inhibitors, SGLT2 inhibitors, SGLT2+DPP-4 inhibitors, or insulin for six months but still had inadequate glycemic control (HbA1c >8.0%). Comparators included injectable GLP-1 RAs and SGLT2 inhibitors combined with DPP-4 inhibitors. IQVIA CORE Diabetes Model (version 9.0) was used to simulate diabetes progression, with baseline characteristics from Taiwan Diabetes Registry Database and the clinical efficacy data from PIONEER phase 3 trials. Relative efficacy of oral semaglutide versus comparators was obtained from head-to-head trials (PIONEER 4 and 10) in Asian populations and meta-analyses. Medical costs in the model included expenses for drugs, disease management, complications, and side effects. Time horizon was lifetime and discount rate was 3% based on pricing data in 2022. Probabilistic sensitivity analyses (PSA) and scenario analyses were conducted.
RESULTS: Oral semaglutide increased QALYs by 0.13 and 0.04 and costs by €571 and €692; the ICERs were €4,248 and €19,595 compared to liraglutide and dulaglutide. Additionally, oral semaglutide was dominant compared to other treatments. The results of PSA showed that, when using Taiwan’s 2022 GDP per capita as the willingness-to-pay threshold, the probabilities of oral semaglutide being cost-effective were 86.5% (compared to ertugliflozin plus sitagliptin), 95.5% (compared to dapagliflozin plus saxagliptin), and 97.9% (compared to empagliflozin plus linagliptin).
CONCLUSIONS: Oral semaglutide is a cost-effective option for T2DM patients who have received metformin or sulfonylurea combined with DPP-4 inhibitors, SGLT2 inhibitors, SGLT2+DPP-4 inhibitors, or insulin for six months but continue to experience inadequate glycemic control.
METHODS: This study targeted T2DM patients who received metformin or sulfonylurea combined with DPP-4 inhibitors, SGLT2 inhibitors, SGLT2+DPP-4 inhibitors, or insulin for six months but still had inadequate glycemic control (HbA1c >8.0%). Comparators included injectable GLP-1 RAs and SGLT2 inhibitors combined with DPP-4 inhibitors. IQVIA CORE Diabetes Model (version 9.0) was used to simulate diabetes progression, with baseline characteristics from Taiwan Diabetes Registry Database and the clinical efficacy data from PIONEER phase 3 trials. Relative efficacy of oral semaglutide versus comparators was obtained from head-to-head trials (PIONEER 4 and 10) in Asian populations and meta-analyses. Medical costs in the model included expenses for drugs, disease management, complications, and side effects. Time horizon was lifetime and discount rate was 3% based on pricing data in 2022. Probabilistic sensitivity analyses (PSA) and scenario analyses were conducted.
RESULTS: Oral semaglutide increased QALYs by 0.13 and 0.04 and costs by €571 and €692; the ICERs were €4,248 and €19,595 compared to liraglutide and dulaglutide. Additionally, oral semaglutide was dominant compared to other treatments. The results of PSA showed that, when using Taiwan’s 2022 GDP per capita as the willingness-to-pay threshold, the probabilities of oral semaglutide being cost-effective were 86.5% (compared to ertugliflozin plus sitagliptin), 95.5% (compared to dapagliflozin plus saxagliptin), and 97.9% (compared to empagliflozin plus linagliptin).
CONCLUSIONS: Oral semaglutide is a cost-effective option for T2DM patients who have received metformin or sulfonylurea combined with DPP-4 inhibitors, SGLT2 inhibitors, SGLT2+DPP-4 inhibitors, or insulin for six months but continue to experience inadequate glycemic control.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE213
Topic
Economic Evaluation, Health Policy & Regulatory, Real World Data & Information Systems
Topic Subcategory
Trial-Based Economic Evaluation
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Urinary/Kidney Disorders