Introduction: In the SUSTAIN 7 randomized controlled trial, once-weekly subcutaneous semaglutide (OW) subcutaneous (s.c.) 0.5mg was associated with greater reduction in glycated hemoglobin (HbA_1c) and body weight in people with type 2 diabetes mellitus (T2DM) comparing dulaglutide 1.5mg. The present study estimated the annual cost per patient achieving HbA_1c treatment targets and weight loss responses with OW s.c. semaglutide and dulaglutide in the Chinese healthcare system setting over a one-year period.

Methods: The proportions of patients achieving single and composite endpoints related to glycemic control, body weight, and hypoglycemia outcomes were taken from SUSTAIN 7. The annual cost included medication cost and needle cost. Cost of control was calculated as the annual cost per patient of each medication, expressed in 2020 RMB (CNY), divided by the proportion of patients achieving each endpoint.

Results: OW s.c. semaglutide 0.5mg was more effective at bringing patients to each of the endpoints and showed lower costs of control for all modeled endpoints. The cost per patient achieving the triple composite endpoint was CNY 9,598 with OW s.c. semaglutide 0.5mg and CNY 13,395 with dulaglutide 1.5mg, representing a 40% larger cost with dulaglutide 1.5mg. For each patient achieving an endpoint of HbA_1c≤6.5%，HbA_1c＜7%, ≥1.0% HbA_1c reduction with≥3.0% weight loss, weight loss≥5% and weight loss≥10%, the cost would be 32%, 28%, 92%, 86% and 121% larger with dulaglutide 1.5mg than with OW s.c. semaglutide 0.5mg, respectively.

Conclusions: OW s.c. semaglutide 0.5mg provides better value for money than dulaglutide 1.5mg for the treatment of people with T2DM in China.