Lower Drug Cost of Successfully Treating Patients with Type 2 Diabetes to Targets with Once-Weekly Semaglutide versus Once-weeklyDulaglutide in Japan: A Short-Term Cost-Effectiveness Analysis.

Abstract

In the head-to-head trial (SUSTAIN 7), the novel, injectable, once-weekly GLP-1 analogue semaglutide showed superiority in both glycemic outcomes and body weight reduction, compared with once-weeklydulaglutide in the treatment of type 2 diabetes (T2D). However, no economic evaluation using these data has yet been conducted in the Japanese setting. The objective of this analysis was to assess the short-term cost-effectiveness in Japan of once-weekly semaglutide 0.5mg (the approved maintenance dose in Japan) compared withonce-weekly dulaglutide 0.75mg (the only licensed dose in Japan) over a 1-year period using Japanese cost data. Responder endpoints were obtained from the SUSTAIN 7 trial to assess the cost of successfully treating patients to these targets ("cost of control"). Responder endpoint definitions consisted of single, dual, and triple composite endpoints related to glycemic control, body weight, and hypoglycemia outcomes. The cost of treatment was accounted from a healthcare payer perspective, capturing drug costs only. Treatment with once-weekly semaglutide 0.5mg was associated with a lower cost and a lower cost per patient treated to target for all endpoints, compared with once-weeklydulaglutide 0.75mg. For each JPY1 spent on bringing patients to target with once-weekly semaglutide 0.5mg, JPY1.58, JPY1.44, JPY1.60, JPY2.10, and JPY2.33 would need to be spent on once-weeklydulaglutide 0.75mg to achieve an equivalent outcome for endpoints of HbA1c ≤ 6.5%, HbA1c < 7.0%, HbA1c < 7.0% without hypoglycemia, and no weight gain, weight loss ≥ 5%, and ≥ 1.0% HbA1c reduction and ≥ 3.0% weight loss, respectively. These findings suggest that once-weekly semaglutide is a cost-effective treatment option compared withonce-weekly dulaglutide for patients with T2D in Japan. In the future, this finding should be extrapolated to traditional long-term cost-effectiveness analysis, using common outcomes such as quality-adjusted life years.