Long-Term Cost-Effectiveness of Subcutaneous Once-Weekly Semaglutide Versus Polyethylene Glycol Loxenatide for Treatment of Type 2 Diabetes Mellitus in China

Lei Liu; Zhen Ruan; Carolina Oi Lam Ung; Yawen Zhang; Yang Shen; Sheng Han; Ruxu Jia; Jingtao Qiao; Hao Hu; Lixin Guo

doi:10.1007/s13300-022-01336-7

Long-Term Cost-Effectiveness of Subcutaneous Once-Weekly Semaglutide Versus Polyethylene Glycol Loxenatide for Treatment of Type 2 Diabetes Mellitus in China

Diabetes Ther. 2023 Jan;14(1):93-107. doi: 10.1007/s13300-022-01336-7. Epub 2022 Nov 22.

Authors

Lei Liu^#¹, Zhen Ruan^#², Carolina Oi Lam Ung^{2

3}, Yawen Zhang⁴, Yang Shen⁵, Sheng Han⁶, Ruxu Jia⁷, Jingtao Qiao⁸, Hao Hu^{9

10}, Lixin Guo¹¹

Affiliations

¹ Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
² State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China.
³ Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China.
⁴ Novo Nordisk (China) Pharmaceuticals Co., Ltd., Beijing, China.
⁵ School of Public Health, Peking University, Beijing, China.
⁶ International Research Center for Medicinal Administration, Peking University, Beijing, China.
⁷ Global Business School for Health, University College London, Gower Street, London, WC1E 6BT, UK.
⁸ Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
⁹ State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China. haohu@um.edu.mo.
¹⁰ Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China. haohu@um.edu.mo.
¹¹ Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China. glx1218@163.com.

^# Contributed equally.

Abstract

Objective: This study aimed to evaluate the long-term cost-effectiveness of once-weekly subcutaneous semaglutide versus polyethylene glycol loxenatide (PEG-loxenatide) in patients with type 2 diabetes uncontrolled on metformin, from a Chinese healthcare systems perspective.

Methods: The study applied the Swedish Institute of Health Economics Diabetes Cohort Model to evaluate the long-term clinical and economic outcomes of once-weekly treatment of semaglutide at 0.5 mg and 1.0 mg, respectively, versus PEG-loxenatide 0.2 mg, over a 40-year time horizon. Baseline cohort characteristics were collected from the SUSTAIN China trial. A network meta-analysis was conducted to obtain comparative treatment effects of once-weekly semaglutide and PEG-loxenatide based on two phase 3a clinical trials. Drug costs were sourced from the national bidding price of China. Outcomes were discounted at 5.0% per annum. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to assess the uncertainty of the base-case results.

Results: When compared with PEG-loxenatide 0.2 mg, the projections of outcomes over the 40-year time horizon in patients with type 2 diabetes uncontrolled on metformin showed that treatment with once-weekly semaglutide 0.5 mg and 1.0 mg were associated with improved discounted life expectancy by 0.08 and 0.12 years, and improved discounted quality-adjusted life expectancy by 0.16 and 0.22 quality-adjusted life-years, respectively. Once-weekly semaglutide 0.5 mg and 1.0 mg were achieved at lifetime cost savings of 19,309 China Yuan (CNY) and 10,179 CNY, respectively. Sensitivity analyses verified the robustness of the results.

Conclusion: From the perspective of Chinese healthcare systems, treatment with once-weekly subcutaneous semaglutide represents a dominant option versus PEG-loxenatide for patients with type 2 diabetes uncontrolled on metformin.

Keywords: China; Cost-effectiveness analysis; Glucagon-like peptide-1 analogue; PEG-loxenatide; Semaglutide; Type 2 diabetes.