Developing a Multi-Indication Wider Societal Value Model to Estimate the Economic Impact of Semaglutide in Canada
Author(s)
Marc Evans, MD1, Donald Husereau, BSc, MSc2, Julie Hviid Hahn-Pedersen, MSc3, Robert King, BSc, MSc4, Jamie Kettle, MMath4, Matthew Hankins, PhD4, Benjamin Bray, PhD, MD4, Maria Luckevich, MBA, MSc5, Christopher Lübker, BSc, MSc3, Soeren Mattke, MD, DSc6.
1University Hospital Llandough, Cardiff, United Kingdom, 2University of Ottawa, Ottawa, ON, Canada, 3Novo Nordisk A/S, Bagsværd, Denmark, 4Health Analytics, Lane Clark & Peacock LLP, London, United Kingdom, 5Novo Nordisk Canada Inc., Mississauga, ON, Canada, 6University of Southern California, Los Angeles, CA, USA.
1University Hospital Llandough, Cardiff, United Kingdom, 2University of Ottawa, Ottawa, ON, Canada, 3Novo Nordisk A/S, Bagsværd, Denmark, 4Health Analytics, Lane Clark & Peacock LLP, London, United Kingdom, 5Novo Nordisk Canada Inc., Mississauga, ON, Canada, 6University of Southern California, Los Angeles, CA, USA.
OBJECTIVES: Health technology assessment (HTA) methods typically assess one indication, focusing on clinical and direct economic outcomes. Multi-indication models are not used given difficulties with overlapping patient populations and potentially unclear decision problems. However, health technologies may have impacts beyond a single indication and significant wider societal value (WSV). A multi-indication WSV model for Canada was developed for semaglutide based on its labelled indications.
METHODS: We conducted a targeted literature review of broader value frameworks to inform model design. Components included in the WSV model are quality-adjusted life years, health care resource utilisation (HCRU), productivity (including formal labour, unpaid labour and care partner productivity), environmental impact and treatment cost. The model used epidemiological inputs to simulate populations with overlapping health states. A treatment effect was applied to estimate the difference in HCRU and productivity to patient-relevant health states.
RESULTS: The WSV of semaglutide in Canada examined the impact on patients with obesity, cardiovascular disease, type 2 diabetes, metabolic dysfunction-associated steatohepatitis and chronic kidney disease. The model used a 5-year time horizon (2025-2029). Baseline prevalences were estimated using US NHANES data adapted for Canada. World Obesity Atlas projections were combined with Canadian population projections to forecast disease prevalence through to 2029. Clinical efficacy data from pivotal trials of semaglutide were used to estimate treatment effects. Annual HCRU costs were applied to the difference in occurrence of conditions between baseline and treatment populations. Environmental impacts (CO2e emissions, water usage) were estimated using published Canadian literature and unpublished data on file. Productivity was estimated and monetised using a US-based quality of life regression model.
CONCLUSIONS: A WSV approach is feasible and can be used to estimate the wider value of multi-indication medicines. This framework has the potential to be used for other multi-indication health technologies.
METHODS: We conducted a targeted literature review of broader value frameworks to inform model design. Components included in the WSV model are quality-adjusted life years, health care resource utilisation (HCRU), productivity (including formal labour, unpaid labour and care partner productivity), environmental impact and treatment cost. The model used epidemiological inputs to simulate populations with overlapping health states. A treatment effect was applied to estimate the difference in HCRU and productivity to patient-relevant health states.
RESULTS: The WSV of semaglutide in Canada examined the impact on patients with obesity, cardiovascular disease, type 2 diabetes, metabolic dysfunction-associated steatohepatitis and chronic kidney disease. The model used a 5-year time horizon (2025-2029). Baseline prevalences were estimated using US NHANES data adapted for Canada. World Obesity Atlas projections were combined with Canadian population projections to forecast disease prevalence through to 2029. Clinical efficacy data from pivotal trials of semaglutide were used to estimate treatment effects. Annual HCRU costs were applied to the difference in occurrence of conditions between baseline and treatment populations. Environmental impacts (CO2e emissions, water usage) were estimated using published Canadian literature and unpublished data on file. Productivity was estimated and monetised using a US-based quality of life regression model.
CONCLUSIONS: A WSV approach is feasible and can be used to estimate the wider value of multi-indication medicines. This framework has the potential to be used for other multi-indication health technologies.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE323
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Novel & Social Elements of Value, Work & Home Productivity - Indirect Costs
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Urinary/Kidney Disorders