OBJECTIVES:

Hyperglycaemia and obesity are risk factors that substantially contribute to the burden of type-2-diabetes mellitus (T2DM). Treatments that decrease levels of both risk factors may reduce morbidity, mortality and improve Quality of Life. Economic considerations are of importance in the choice of treatments. From payers perspective treatment objectives include efficient target attainment of glycaemia (HbA1c) and weight, at limited expenditure.

Semaglutide once-weekly (OW) is a novel glucagon-like peptide-1 analogue indicated for treatment of patients with T2DM. A cost-of-control analysis was conducted to compare costs of obtaining clinically relevant improvements in both HbA1c and body weight with semaglutide OW versus relevant alternatives over a one year time-period.

METHODS:

Randomized clinical trials (phase 3a/3b) provide evidence for the proportion of patients reaching a reduction of both ≥1% in HbA1c and 5.0% in weight with semaglutide OW (1 mg) versus sitagliptin, exenatide extended-release (ER) and insulin glargine, and ≥1% in HbA1c and ≥3.0% in weight versus dulaglutide. Annual treatment costs were based on Norwegian drug costs for maintenance doses over one year.

RESULTS:

The number needed to treat to reach the combined target was significantly lower for semaglutide OW than alternatives (semaglutide OW (1.85) versus sitagliptin (11.11); semaglutide OW (2.33) versus exenatide ER (7.69); semaglutide OW (2.44) versus insulin glargine (50.00); semaglutide OW (1.47) versus dulaglutide (2.86)). The cost-of-control analysis demonstrates that annual costs of reaching the combined target were higher for sitagliptin (€2,910), exenatide ER (€6,920), insulin glargine (€27,360) and dulaglutide (€1,650) than for semaglutide OW.

CONCLUSIONS:

Semaglutide OW is more efficacious and less costly than sitagliptin, exenatide ER, insulin glargine and dulaglutide in reaching clinically important treatment targets in T2DM. Potential reductions in short-and long-term complications associated with reduced risk factor levels of HbA1c and weight can be achieved at lower costs with semaglutide OW than relevant alternatives in Norway.