AccScience Publishing / GHES / Online First / DOI: 10.36922/ghes.3032
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ORIGINAL RESEARCH ARTICLE

Short-term cost-effectiveness of oral semaglutide versus empagliflozin, sitagliptin, and liraglutide in the treatment of Type 2 diabetes in Greece

Panagiotis Papantoniou1* ,  Anastasia Papageorgiou2
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1 Department of Public Health Policy, Faculty of Public Health, University of West Attica, Athens, Greece
2 Department of Plant Pathology, Faculty of Crop Science, Agricultural University of Athens, Athens, Greece
GHES, 3032 https://doi.org/10.36922/ghes.3032
Submitted: 27 February 2024 | Accepted: 13 June 2024 | Published: 15 October 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Diabetes is a significant global health concern, affecting more than 540 million people worldwide and imposing a substantial financial burden on health systems and societies. This study evaluates the cost per patient of achieving treatment targets with oral semaglutide compared to empagliflozin, sitagliptin, and liraglutide in patients with Type 2 diabetes in Greece. The analysis focuses on seven outcomes, including hemoglobin A1C levels, avoidance of hypoglycemia, and weight loss, with costs calculated in 2024 EUR, excluding patient copayments. The annual treatment costs were EUR 1,210.04 for oral semaglutide, EUR 528.04 for empagliflozin, EUR 260.51 for sitagliptin, and EUR 1,542.87 for liraglutide. Although a higher proportion of patients achieved treatment goals with oral semaglutide, it was associated with a higher cost of control across most outcomes compared to empagliflozin (mean probabilistic sensitivity analysis [PSA] difference: EUR 839.45) and sitagliptin (mean PSA difference: EUR 1,041.50). In contrast, oral semaglutide demonstrated a consistently lower cost of control compared to liraglutide across all treatment targets (mean PSA difference: EUR −3,779.23). This analysis confirms that the cost of control of oral semaglutide varies significantly depending on the treatment target, suggesting that, without changes in its list or net price, it may not be the most cost-effective option compared to empagliflozin and sitagliptin in Greece.

Keywords
Cost of control
Short-term cost-effectiveness
Type-2 diabetes
Glucagon-like peptide-1 receptor agonists
Greece
Funding
None.
Conflict of interest
The authors declare they have no conflicts of interest.
References
  1. American Diabetes Association. (2022). Standards of medical care in diabetes-2022 abridged for primary care providers. Clinical Diabetes, 40(1):10-38. https://doi.org/10.2337/cd22-as01

 

  1. Boye, K.S., Matza, L.S., Walter, K.N., Van Brunt, K., Palsgrove, A.C., & Tynan, A. (2011). Utilities and disutilities for attributes of injectable treatments for type 2 diabetes. The European Journal of Health Economics, 12(2):219-230. https://doi.org/10.1007/s10198-010-0224-8

 

  1. Buse, J.B., Wexler, D.J., Tsapas, A., Rossing, P., Mingrone, G., Mathieu, C., et al. (2020). 2019 update to: Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, 43(2):487-493. https://doi.org/10.2337/dci19-0066

 

  1. Curry, S.J., Krist, A.H., Owens, D.K., Barry, M.J., Caughey, A.B., Davidson, K.W., et al. (2018). Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults: US Preventive Services Task Force recommendation statement. JAMA, 320(11):1163-1171. https://doi.org/10.1001/jama.2018.13022

 

  1. Davies, M.J., D’Alessio, D.A., Fradkin, J., Kernan, W.N., Mathieu, C., Mingrone, G., et al. (2018). Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia, 61(12):2461-2498. https://doi.org/10.2337/dci18-0033

 

  1. Einarson, T.R., Acs, A., Ludwig, C., & Panton, U.H. (2018). Prevalence of cardiovascular disease in type 2 diabetes: A systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovascular Diabetology, 17(1):83. https://doi.org/10.1186/s12933-018-0728-6

 

  1. Fu, A.Z., & Sheehan, J.J. (2016). Treatment intensification for patients with type 2 diabetes and poor glycaemic control. Diabetes, Obesity and Metabolism, 18(9):892-898. https://doi.org/10.1111/dom.12683

 

  1. Handelsman, Y., Bloomgarden, Z.T., Grunberger, G., Umpierrez, G., Zimmerman, R.S., Bailey, T.S., et al. (2015). American Association of Clinical Endocrinologists and American College of Endocrinology-clinical practice guidelines for developing a diabetes mellitus comprehensive care plan 2015-executive summary. Endocrine Practice, 21(4):413-437. https://doi.org/10.4158/EP15672.GL

 

  1. Hansen, B.B., Nuhoho, S., Ali, S.N., Dang-Tan, T., Valentine, W.J., Malkin, S.J.P., et al. (2020). Oral semaglutide versus injectable glucagon-like peptide-1 receptor agonists: A cost of control analysis. Journal of Medical Economics, 23(6):650-658. https://doi.org/10.1080/13696998.2020.1722678

 

  1. Hunt, B., Hansen, B.B., Ericsson, Å., Kallenbach, K., Ali, S.N., Dang-Tan, T., et al. (2019). Evaluation of the cost per patient achieving treatment targets with oral semaglutide: A short-term cost-effectiveness analysis in the United States. Advances in Therapy, 36(12):3483-3493. https://doi.org/10.1007/s12325-019-01125-y

 

  1. Huxley, R., Barzi, F., & Woodward, M. (2006). Excess risk of fatal coronary heart disease associated with diabetes in men and women: Meta-analysis of 37 prospective cohort studies. BMJ, 332(7533):73-78. https://doi.org/10.1136/bmj.38678.389583.7C

 

  1. International Diabetes Federation. (2021). IDF Diabetes Atlas. 10th Brussels, Belgium: International Diabetes Federation. Available from: https://www.diabetesatlas.org [Last accessed on 2024 Feb 20]

 

  1. Kanavos, P., van den Aardweg, S., & Schurer, W. (2012). Diabetes Expenditure, Burden of Disease and Management in 5 EU Countries. LSE Health, London School of Economics. Available from: https://www.lse.ac.uk/business/consulting/ assets/documents/diabetes-expenditure-burden-of-disease-and-management-in-5-eu-countries.pdf [Last accessed on 2024 Feb 20]

 

  1. Khunti, K., Ceriello, A., Cos, X., & De Block, C. (2018). Achievement of guideline targets for blood pressure, lipid, and glycaemic control in type 2 diabetes: A meta-analysis. Diabetes Research and Clinical Practice, 137:137-148. https://doi.org/10.1016/j.diabres.2017.12.004

 

  1. Kim, E.H., Kim, H.K., Lee, M.J., Bae, S.J., Kim, K.W., & Choe, J. (2022). Association between type 2 diabetes and skeletal muscle quality assessed by abdominal computed tomography scan. Diabetes Metabolism Research and Reviews, 38(4):e3513. https://doi.org/10.1002/dmrr.3513

 

  1. Makrilakis, K., Kalpourtzi, N., Ioannidis, I., Iraklianou, S., Raptis, A., Sotiropoulos, A., et al. (2021). Prevalence of diabetes and pre-diabetes in Greece. Results of the First National Survey of Morbidity and Risk Factors (EMENO) study. Diabetes Research and Clinical Practice, 172:108646. https://doi.org/10.1016/j.diabres.2020.108646

 

  1. Morrish, N.J., Wang, S.L., Stevens, L.K., Fuller, J.H., & Keen, H. (2001). Mortality and causes of death in the WHO multinational study of vascular disease in diabetes. Diabetologia, 44(1):14-21. https://doi.org/10.1007/PL00002934

 

  1. Pantalone, K.M., Misra-Hebert, A.D., Hobbs, T.M., Ji, X., Kong, S.X., Milinovich, A., et al. (2018). Clinical inertia in type 2 diabetes management: Evidence from a large, real-world data set. Diabetes Care, 41(7):e113-e114. https://doi.org/10.2337/dc18-0116

 

  1. Pratley, R., Amod, A., Hoff, S.T., Kadowaki, T., Lingvay, I., Nauck, M., et al. (2019). Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): A randomised, double-blind, phase 3a trial. The Lancet, 394(10192):39-50. https://doi.org/10.1016/S0140-6736(19)31271-1

 

  1. Ridderstrale, M., Evans, L.M., Jensen, H.H., Bøgelund, M., Jensen, M.M., Ericsson, Å., et al. (2016). Estimating the impact of changes in HbA1c, body weight and insulin injection regimen on health related quality-of-life: A time trade off study. Health and Quality of Life Outcomes, 14(1):13. https://doi.org/10.1186/s12955-016-0411-0

 

  1. Rodbard, H.W., Rosenstock, J., Canani, L.H., Deerochanawong, C., Gumprecht, J., Lindberg, S.Ø., et al. (2019). Oral semaglutide versus empagliflozin in patients with type 2 diabetes uncontrolled on metformin: The PIONEER 2 trial. Diabetes Care, 42(12):2272-2281. https://doi.org/10.2337/dc19-0883

 

  1. Rosenstock, J., Allison, D., Birkenfeld, A.L., Blicher, T.M., Deenadayalan, S., Jacobsen, J.B., et al. (2019). Effect of additional oral semaglutide vs sitagliptin on glycated hemoglobin in adults with type 2 diabetes uncontrolled with metformin alone or with sulfonylurea: The PIONEER 3 randomized clinical trial. JAMA, 321(15):1466-1480. https://doi.org/10.1001/jama.2019.2942

 

  1. Rubin, R.R., & Peyrot, M. (1999). Quality of life and diabetes. Diabetes Metabolism Research and Reviews, 15(3):205-218. h t t p s : / / d o i . o r g / 1 0 . 1 0 0 2 / ( s i c i ) 1 5 2 0 - 7560(199905/06)15:3<205:aid-dmrr29>3.0.co;2-o

 

  1. UK Prospective Diabetes Study Group. (1999). Quality of life in type 2 diabetic patients is affected by complications but not by intensive policies to improve blood glucose or blood pressure control (UKPDS 37). Diabetes Care, 22(7): 1125-1130. https://doi.org/10.2337/diacare.22.7.1125
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Global Health Economics and Sustainability, Electronic ISSN: 2972-4570 Published by AccScience Publishing
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