OBJECTIVES: Clinical data indicate that oral semaglutide and dulaglutide are equally efficacious and have a comparable safety profile in the management of type 2 diabetes (T2D). We evaluated the annual cost of treatment with oral semaglutide compared with dulaglutide in patients with T2DM requiring treatment intensification with a GLP-1 receptor agonist in South Korea.

METHODS: A cost-minimisation analysis was performed from the perspective of the South Korea’s public healthcare system, and in accordance with the South Korean HIRA guidelines for pharmacoeconomic analyses. The time horizon was 1 year. Patients whose diabetes was inadequately controlled on metformin and sulfonylurea (oral drug combination therapy group) and those inadequately controlled on insulin, with or without metformin (insulin combination therapy group) were analysed separately. Cost items were identified by reviewing diabetes treatment guidelines, clinical trials, and published economic evaluations. Only direct healthcare costs were included, such as outpatient consultation and examination fees, dispensing fees and medication costs. Costs were calculated using health-insurance-price-related data, statistical data, and related literature. Unit costs for 3, 7, and 14 mg oral semaglutide were 1,664 KRW, 3,660 KRW and 5,940 KRW, and 19,796 KRW and 32,129 KRW, respectively, for 0.75 and 1.5 mg dulaglutide.

RESULTS: The expected total annual cost per patient in the oral combination group was 1,928,701 KRW for oral semaglutide and 1,931,790 KRW for dulaglutide, a saving of 3,089 KRW. In the insulin combination group, the costs were 2,375,793 KRW for oral semaglutide and 2,378,882 KRW for dulaglutide, a saving of 3,089 KRW.

CONCLUSIONS: Cost-minimisation analysis found that oral semaglutide, compared with dulaglutide, leads to a small per-patient saving, regardless of baseline therapy, and is therefore in practice likely to be save money compared to dulaglutide in patients with T2DM in South Korea.