PDB25 The Cost-Effectiveness of ORAL Semaglutide in Patients Treated with Currently Available GLP-1 Receptor Agonists - a UK Perspective

Abstract

Oral semaglutide is now available in the United States and Canada, and received marketing authorisation in April 2020 from the EMA for use in Europe. There are already a number of glucagon-like peptide 1 receptor agonists (GLP-1RA) available in either once-daily or once-weekly injectable formulations; semaglutide is the first orally administered GLP-1RA. Unlike the majority of economic evaluations which focus on a specific comparator, the objective of this assessment takes a holistic, real-world approach and compares the cost-effectiveness of oral semaglutide with the currently prescribed GLP-1RA class. To inform the calculations, long-term economic evaluations were conducted in the IQVIA CORE Diabetes Model using the results of a published network meta-analysis and UK-specific costs of treatment and diabetes-related complications. The results of these model simulations were then weighted according to current country-specific GLP-1RA market shares (Feb–Apr 2020). Costs of diabetes treatments were taken from the Monthly Index of Medical Specialities, June 2020, with costs and impact on quality of life of diabetes-related complications taken from published sources. The UK standard discount rate of 3.5% was used. The use of oral semaglutide resulted in reduced lifetime costs and quality-adjusted life-years (QALY; £24,309 and 8.61, respectively) versus injectable GLP-1RAs (£24,561 and 8.59, respectively). These results show that oral semaglutide is dominant (less costly and more effective), with predicted savings of £251 and an increase of 0.03 QALYs per patient when compared with the current market-mix of GLP-1 RA treatments. The results of this analysis show that oral semaglutide is a cost-effective treatment option for patients for whom a GLP-1RA is appropriate. The comparison provided here is relevant to payers, as it demonstrates what they are currently paying versus the new oral formulation. Physician and patient preference is important when selecting which GLP-1RA to prescribe for a patient.