OBJECTIVES: This study aims to assess the cost-effectiveness of tirzepatide 10mg and 15mg once weekly (QW) compared to placebo for type 2 diabetes (T2D) patients with obesity in the United States (US).

METHODS: The Building, Relating, Assessing, and Validating Outcomes (BRAVO) of Diabetes Model was used to assess cost-effectiveness of tirzepatide (10mg and 15mg QW) versus placebo among T2D individuals with obesity who received dietary and exercise guidance or oral antihyperglycemic agents from the US healthcare perspective, using three simulation durations of forty, thirty, and twenty years. The clinical data was derived from the SURMOUNT-2 trial, a 72-week, double-blind, randomized, multicenter, placebo-controlled phase 3 trial, and was assumed to have a treatment escalation after five years. The costs were calculated from the data of the SURMOUNT-2 trial, supplemented by medication prices from the GoodRx and health utilities from the literature. One-way sensitivity analysis and probability sensitivity analysis (PSA) were used to examine the robustness. The willingness to pay threshold for the incremental cost-effectiveness ratio (ICER) was 100,000 per quality-adjusted life year (QALY) gained.

RESULTS: Compared with placebo, tirzepatide 15mg QW gained additional 0.65, 0.90, and 0.46 QALYs over 40, 30, and 20 years, respectively. Correspondingly, the ICERs for tirzepatide 15mg QW were $33,032, $31,085, and $42,272 per QALY for the three durations. Tirzepatide 10mg QW were projected at 0.57, 0.52, and 0.40 QALY gains for 40, 30, 20 years, respectively, with ICERs of $39,628, $38,330, and $51,969 per QALY. With PSA, tirzepatide 15mg QW has 94%, 100%, and 99% probability cost-effective for the three durations, respectively; 10mg weekly has 92%, 87%, and 93% probability.

CONCLUSIONS: The BRAVO diabetes model simulation indicates that tirzepatide 10 mg and 15 mg QW are cost-effective interventions for individuals with T2D and obesity in all durations.