Abstract 13465: Tirzepatide vs. Semaglutide for Secondary Prevention of Major Adverse Cardiovascular Events in Patients With Type 2 Diabetes Mellitus With an Initial HbA1c of >8.5 - A Value for Money Analysis

Abstract

Introduction: Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA) indicated to reduce major adverse cardiovascular events (MACE) in patients with Type-2 Diabetes Mellitus (T2DM) and established cardiovascular disease. Tirzepatide is a novel glucose-dependent insulinotropic polypeptide (GIP) and GLP-1RA for the same purpose. Comparing the value for money of the two therapies in people with poorly controlled diabetes is essential for prioritization. Methods: We calculated the cost needed to prevent one MACE with either drug by multiplying the annualized number needed to treat (aNNT) to prevent one MACE by the annual cost of the therapy. Efficacy estimates were extracted from pre-specified cohorts of patients with an initial HbA1c above 8.5% in the SURPASS and SUSTAIN-6 trials. Drug costs were based on US GoodRx prices as of February 2023. Results: The aNNT to prevent one MACE in patients with an initial HbA1c of >8.5 with tirzepatide was 79 (95% CI: 44-∞) compared to 78 (95% CI: 42-∞) with semaglutide. The annual cost of tirzepatide is $13,286 versus $17,495 for semaglutide. Accordingly, the CNT to prevent one MACE with tirzepatide is $1,049,594 (95% CI: $584,584-∞) compared to $1,364,611 (95% CI: $734,790-∞) with semaglutide. Conclusions: Tirzepatide provides slightly better, but comparable, value for money than semaglutide when prescribed for secondary prevention of MACE in patients with an initial HbA1c >8.5.