The long-term cost-effectiveness of once-weekly semaglutide versus sitagliptin for the treatment of type 2 diabetes in China.

IF 2.7 3区 经济学 Q1 ECONOMICS
Shuyan Gu, Jinghong Gu, Xiaoyong Wang, Xiaoling Wang, Lu Li, Hai Gu, Biao Xu
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引用次数: 0

Abstract

Background: To estimate the long-term cost-effectiveness of once-weekly semaglutide versus sitagliptin as an add-on therapy for type 2 diabetes patients inadequately controlled on metformin in China, to better inform healthcare decision making.

Methods: The Cardiff diabetes model which is a Monte Carlo micro-simulation model was used to project short-term effects of once-weekly semaglutide versus sitagliptin into long-term outcomes. Short-term data of patient profiles and treatment effects were derived from the 30-week SUSTAIN China trial, in which 868 type 2 diabetes patients with a mean age of 53.1 years inadequately controlled on metformin were randomized to receive once-weekly semaglutide 0.5 mg, once-weekly semaglutide 1 mg, or sitagliptin 100 mg. Costs and quality-adjusted life years (QALYs) were estimated from a healthcare system perspective at a discount rate of 5%. Univariate sensitivity analysis, scenario analysis, and probabilistic sensitivity analysis were conducted to test the uncertainty.

Results: Over patients' lifetime projections, patients in both once-weekly semaglutide 0.5 mg and 1 mg arms predicted less incidences of most vascular complications, mortality, and hypoglycemia, and lower total costs compared with those in sitagliptin arm. For an individual patient, compared with sitagliptin, once-weekly semaglutide 0.5 mg conferred a small QALY improvement of 0.08 and a lower cost of $5173, while once-weekly semaglutide 1 mg generated an incremental QALY benefit of 0.12 and a lower cost of $7142, as an add-on to metformin. Therefore, both doses of once-weekly semaglutide were considered dominant versus sitagliptin with more QALY benefits at lower costs.

Conclusion: Once-weekly semaglutide may represent a cost-effective add-on therapy alternative to sitagliptin for type 2 diabetes patients inadequately controlled on metformin in China.

在中国,每周一次的塞马鲁肽与西他列汀治疗 2 型糖尿病的长期成本效益。
背景:目的:估算在中国使用二甲双胍治疗控制不佳的2型糖尿病患者时,每周一次的塞马鲁肽与西格列汀作为附加疗法的长期成本效益,以便更好地为医疗决策提供依据:卡迪夫糖尿病模型是一种蒙特卡洛微观模拟模型,用于预测每周一次的塞马鲁肽与西格列汀的短期疗效对长期疗效的影响。在这项为期30周的SUSTAIN中国试验中,868名平均年龄为53.1岁、二甲双胍治疗效果不佳的2型糖尿病患者被随机分配接受每周一次的塞马鲁肽0.5毫克、每周一次的塞马鲁肽1毫克或西他列汀100毫克治疗。从医疗保健系统的角度估算了成本和质量调整生命年(QALYs),贴现率为 5%。为测试不确定性,进行了单变量敏感性分析、情景分析和概率敏感性分析:与西格列汀治疗组相比,在患者的整个生命周期中,每周一次的塞马鲁肽 0.5 毫克治疗组和 1 毫克治疗组患者的大多数血管并发症、死亡率和低血糖发生率都较低,总成本也较低。就单个患者而言,与西格列汀相比,作为二甲双胍的附加用药,0.5 毫克每周一次的塞马鲁肽可带来 0.08 美元的小幅 QALY 改善,成本为 5173 美元,而 1 毫克每周一次的塞马鲁肽可带来 0.12 美元的 QALY 增益,成本为 7142 美元。因此,与西格列汀相比,两种剂量的每周一次的塞马鲁肽都被认为具有更高的QALY收益和更低的成本:在中国,对于二甲双胍治疗效果不佳的2型糖尿病患者,每周一次的塞马鲁肽可能是一种替代西格列汀的经济有效的附加疗法。
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来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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