Abstract

Objectives

To evaluate the carbon footprint and clinical outcomes of once-weekly subcutaneous semaglutide in patients with type 2 diabetes mellitus (T2DM) in the United Kingdom.

Methods

Using the IQVIA Core Diabetes Model, environmental and clinical impacts were projected over a lifetime horizon from the National Health Services perspective. Data from the SUSTAIN-2 (patients with T2DM) and SUSTAIN-6 (patients with T2DM and established cardiovascular [CV] risk) trials were used to compare semaglutide with sitagliptin and placebo, respectively. Outcomes included life expectancy measured in life-years (LYs) and quality-adjusted life expectancy measured in quality-adjusted life-years (QALYs) gained, incidence of diabetes-related complications and adverse events, carbon emissions, and incremental carbon footprint effectiveness ratios.

Results

In patients with T2DM, semaglutide dominates sitagliptin, with higher discounted LYs (0.096) and QALYs (0.095) gains, a 6.9% reduction in diabetes-related complications and adverse events, and reduced lifetime carbon emissions by 9.3% (13,899 kg carbon dioxide equivalent emissions [CO e] versus 15,319 kg CO e). Similarly, in patients with T2DM and established CV risk, semaglutide showed higher discounted LYs (0.206) and QALYs (0.164), with reductions in all complications except heart failure-related hospitalizations versus placebo. Lifetime carbon emissions were 5.2% lower with semaglutide (14,546 kg CO e versus 15,341 kg CO e), again with a dominant carbon footprint effectiveness ratio. The reduction in CO was mainly driven by reduced complications and treatment needs. Sensitivity analyses supported the robustness of the results.

Conclusion

Semaglutide offers environmental advantages over sitagliptin for patients with T2DM overall and over standard of care for those with established CV risk.