November 12, 2020
For patients with type 2 diabetes mellitus not controlled with metformin, intensification with oral semaglutide 14 mg daily is more costly than oral sitagliptin 100 mg daily over 5 years, according to a study published online in PharmacoEconomics.
“The results indicated that the increase in treatment cost with the use of oral semaglutide 14 mg outweighed the cost savings in other categories,” researchers wrote.
The study took a US payer perspective to investigate the budget impact over 5 years of oral semaglutide compared with oral sitagliptin for patients not achieving a target glycated hemoglobin (HBA1c) level despite metformin treatment. Researchers used predictive model equations and clinical trial data for each treatment to estimate costs and effects for a hypothetical health care plan of 1 million lives and the full US population. Semaglutide was approved for blood glucose control in 2019 as the first oral glucagon-like peptide 1 receptor agonist.
Over 5 years, the cost of an average patient treated with oral with sitagliptin 100 mg would increase $16,562 if that patient was treated with oral semaglutide 14 mg instead—a jump of 70.7%, according to the study. A hypothetical payer would spend an additional 7.1% over 5 years for every 10% of patients who switch from sitagliptin to semaglutide.
“Changing the cost of oral semaglutide 14 mg had the greatest impact on model results,” researchers wrote. “The findings from the analysis were consistent across a range of alternate model inputs.”
The study was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
Wehler E, Lautsch D, Kowal S, et al. Budget Impact of Oral Semaglutide Intensification versus Sitagliptin among US Patients with Type 2 Diabetes Mellitus Uncontrolled with Metformin [published online ahead of print, 2020 Nov 5]. Pharmacoeconomics. 2020;10.1007/s40273-020-00967-7. doi:10.1007/s40273-020-00967-7