Objective: The objective of the current study was to assess the long-term cost-effectiveness of once-weekly (OW) subcutaneous (s.c.) semaglutide 0.5mg and 1.0mg versus dulaglutide 1.5mg for the treatment of type 2 diabetes, based on the head-to-head SUSTAIN 7 trial, to inform healthcare decision making in China.

Methods: The Swedish Institute of Health Economics Diabetes Cohort Model (IHE-DCM) was used to evaluate the long-term cost and health outcomes of OW s.c. semaglutide and dulaglutide. Analysis was conducted from the perspective of Chinese healthcare system over a time horizon of 40 years. Data of baseline characteristics and treatment effects were sourced from the SUSTAIN 7 clinical trial. Treatment costs and costs of complications were sourced from bidding price and previous publications and all expressed to 2020 CNY. Future costs and outcomes were discounted at 5% per annum. The research results were evaluated through one-way sensitivity analysis and probabilistic sensitivity analysis.

Results: Compared with dulaglutide 1.5mg, OW s.c. semaglutide 0.5mg and 1.0mg were associated with improvements in discounted life expectancy of 0.04 and 0.09 years, respectively, and discounted quality-adjusted life expectancy of 0.08 and 0.19 quality-adjusted life years (QALYs), respectively. Clinical benefits were achieved at reduced costs, with lifetime cost savings of 6,744 CNY with OW s.c. semaglutide 0.5mg and 10,818 CNY with OW s.c. semaglutide 1.0mg, resulting from the reduction of diabetes-related complications. Therefore, both doses of OW s.c. semaglutide were considered dominant versus dulaglutide 1.5mg (improving outcomes and reducing costs). Sensitivity analysis verified the robustness of the research results.

Conclusions: This study showed that OW s.c. semaglutide 0.5mg and OW s.c. semaglutide 1.0mg were estimated to be cost-saving treatment options versus dulaglutide 1.5mg in patients with type 2 diabetes uncontrolled on metformin monotherapy in China.