Assessing the Cost-Effectiveness of Subcutaneous Semaglutide 2.4 mg in the Management of Individuals With Obesity and Prediabetes in England
Author(s)
Mafalda Ramos, MSc1, Sara Larsen, MSc2, Francesco Fusco, PhD3, Mark Lamotte, MD4, Matthew Capehorn, PhD5.
1Th(is)²Modeling, Asse, Belgium, 2Novo Nordisk A/S, Søborg, Denmark, 3Novo Nordisk, Frederiksberg, Denmark, 4Cardiologist - Health economic specialist, Th(is)²Modeling, Asse, Belgium, 5Rotherham Insitute for Obesity, Rotherham, United Kingdom.
1Th(is)²Modeling, Asse, Belgium, 2Novo Nordisk A/S, Søborg, Denmark, 3Novo Nordisk, Frederiksberg, Denmark, 4Cardiologist - Health economic specialist, Th(is)²Modeling, Asse, Belgium, 5Rotherham Insitute for Obesity, Rotherham, United Kingdom.
OBJECTIVES: Pre-diabetes and diabetes are more prevalent in individuals with obesity. Both augments importantly the risk of cardiovascular disease. Semaglutide has proven to reduce weight by about 10-15% and reverse pre-diabetes to normal glucose tolerance (NGT). The aim of this study was to assess the cost-effectiveness of semaglutide plus diet and exercise (D&E) compared with D&E alone in individuals with obesity and pre-diabetes in the UK based on the STEP 10 trial.
METHODS: The published Core Obesity Model was populated with baseline characteristics and treatment efficacy from STEP 10. This study assessed the reversal of pre-diabetes to NGT at 52 weeks. Baseline age and BMI were 53 (SD:11) years and 40.1 (6.9) kg/m². At 52 weeks, semaglutide plus D&E and D&E alone reversed pre-diabetes in 80% and 12% of patients, and decreased BMI with 13.71% and 2.77%, respectively. The perspective of the English NHS was adopted using annual discounting rates of 3.5% on costs and outcomes. Several subgroups were analysed: Different baseline BMI, number of comorbidities present, proportions of pre-diabetes, and different treatment durations. Individuals losing ≥5% of body weight after 20 weeks (responders) were analysed separately.
RESULTS: The treatment duration in the base case analysis was 20 years. The use of semaglutide resulted in 1.105QALY gained at an additional cost of 19,391GBP. The resulting ICER was 17,695GBP/QALY gained. Treatment with semaglutide extended life expectancy by 1.68 years. Ranging treatment duration between 1 year as per STEP 10 trial and lifelong, resulted in an ICER of 7,152 to 22,082GBP/QALY. Results did not differ significantly by subgroup studied. The probabilistic sensitivity analysis showed a 90% chance of semaglutide being cost-effective at a willingness to pay threshold of 20,000GBP/QALY.
CONCLUSIONS: Semaglutide 2.4mg is a cost-effective treatment option for individuals with obesity and pre-diabetes in the UK based on the results of the STEP 10 trial.
METHODS: The published Core Obesity Model was populated with baseline characteristics and treatment efficacy from STEP 10. This study assessed the reversal of pre-diabetes to NGT at 52 weeks. Baseline age and BMI were 53 (SD:11) years and 40.1 (6.9) kg/m². At 52 weeks, semaglutide plus D&E and D&E alone reversed pre-diabetes in 80% and 12% of patients, and decreased BMI with 13.71% and 2.77%, respectively. The perspective of the English NHS was adopted using annual discounting rates of 3.5% on costs and outcomes. Several subgroups were analysed: Different baseline BMI, number of comorbidities present, proportions of pre-diabetes, and different treatment durations. Individuals losing ≥5% of body weight after 20 weeks (responders) were analysed separately.
RESULTS: The treatment duration in the base case analysis was 20 years. The use of semaglutide resulted in 1.105QALY gained at an additional cost of 19,391GBP. The resulting ICER was 17,695GBP/QALY gained. Treatment with semaglutide extended life expectancy by 1.68 years. Ranging treatment duration between 1 year as per STEP 10 trial and lifelong, resulted in an ICER of 7,152 to 22,082GBP/QALY. Results did not differ significantly by subgroup studied. The probabilistic sensitivity analysis showed a 90% chance of semaglutide being cost-effective at a willingness to pay threshold of 20,000GBP/QALY.
CONCLUSIONS: Semaglutide 2.4mg is a cost-effective treatment option for individuals with obesity and pre-diabetes in the UK based on the results of the STEP 10 trial.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE60
Topic
Clinical Outcomes, Economic Evaluation
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity)