Aims Glucagon‐like peptide‐1 (GLP‐1) receptor agonists are appealing as glucose‐lowering therapy for individuals with type 2 diabetes mellitus (T2DM) as they also reduce body weight and are associated with low rates of hypoglycaemia. This analysis assessed the long‐term cost‐effectiveness of semaglutide 0.5 and 1 mg vs dulaglutide 1.5 mg (two once‐weekly GLP‐1 receptor agonists) from a UK healthcare payer perspective, based on the head‐to‐head SUSTAIN 7 trial, to inform healthcare decision making. Materials and Methods Long‐term outcomes were projected using the IQVIA CORE Diabetes Model (version 9.0). Baseline cohort characteristics, changes in physiological parameters and adverse event rates were derived from the 40‐week SUSTAIN 7 trial. Costs to a healthcare payer were assessed, and these captured pharmacy costs and costs of complications. Utilities were taken from published sources. Results Once‐weekly semaglutide 0.5 and 1 mg were associated with improvements in quality‐adjusted life expectancy of 0.04 and 0.10 quality‐adjusted life years, respectively, compared with dulaglutide 1.5 mg. Clinical benefits were achieved at reduced costs, with lifetime cost savings of GBP 35 with once‐weekly semaglutide 0.5 mg and GBP 106 with the once‐weekly semaglutide 1 mg, resulting from fewer diabetes‐related complications due to better glycaemic control. Therefore, both doses of once‐weekly semaglutide were considered dominant vs dulaglutide 1.5 mg (improving outcomes and reducing costs). Conclusions Compared with treatment with dulaglutide, once‐weekly semaglutide represents a cost‐effective option for treating individuals in the UK with T2DM who are not achieving glycaemic control with metformin, projected to both improve clinical outcomes and reduce costs.

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Introduction: Swedish National Diabetes Registry data show a correlation of improved glycemic control in people with type 1 diabetes (T1D) with increased use of diabetes technologies over the past 25 years. However, novel technologies are often associated with a high initial outlay. The aim of the present study was to evaluate the long-term cost-effectiveness of the advanced hybrid closed-loop (AHCL) Mini-Med 780G system versus intermittently scanned continuous glucose monitoring (isCGM) plus self-injection of multiple daily insulin (MDI) or continuous subcutaneous insulin infusion (CSII) in people with T1D in Sweden. Methods: Outcomes were projected over patients' lifetimes using the IQVIA CORE Diabetes Model (v9.0). Clinical data, including

Introduction Once-weekly semaglutide is a novel glucagon-like peptide-1 (GLP-1) analog for the treatment of type 2 diabetes (T2D) that has been associated with greater reductions in glycated hemoglobin (HbA1c) and body weight versus GLP-1 receptor agonists dulaglutide, exenatide extended-release (ER), liraglutide and lixisenatide in the SUSTAIN trial program and a network meta-analysis (NMA). The aim of the present study was to assess the long-term cost-effectiveness of semaglutide versus all available GLP-1 receptor agonists in Denmark, using a clinically orientated treatment approach. Methods Outcomes were projected over patient lifetimes using the IQVIA CORE Diabetes Model. Baseline characteristics and treatment effects were sourced from the corresponding SUSTAIN trials and the NMA. Patients were assumed to initiate GLP-1 receptor agonist therapy and subsequently treatment-intensify according to clinical treatment guidelines, with addition of basal insulin and switching to basal-bolus insulin occurring when HbA1c exceeded recommended targets. Patients were assumed to receive a GLP-1 receptor agonist plus basal insulin therapy once HbA1c levels reached 7.5% and a basal-bolus insulin regimen once HbA1c exceeded 8.0%. Costs were captured in 2017 Danish kroner (DKK), with future costs and outcomes discounted at 3% per annum. Results Primary analyses indicated that semaglutide 0.5 mg and 1 mg were associated with improvements in quality-adjusted life expectancy of 0.11 and 0.34 quality-adjusted life years, respectively, versus dulaglutide, achieved at cost savings of DKK 289 and DKK 13,416, respectively. Supporting analyses indicated that both doses of semaglutide were either cost-effective or dominant versus exenatide ER, liraglutide 1.2 mg and 1.8 mg and lixisenatide. Conclusion Semaglutide represents a cost-effective alternative to other GLP-1 receptor agonist therapies available in Denmark, demonstrating clinical benefits versus dulaglutide, exenatide ER, liraglutide and lixisenatide for the treatment of patients with T2D. Funding Novo Nordisk A/S. Plain Language Summary Plain language summary available for this article. Electronic supplementary material The online version of this article (10.1007/s13300-019-0630-6) contains supplementary material, which is available to authorized users.

Introduction: Healthcare systems aim to maximize the health of the population, but must work within constrained budgets. Therefore, choosing therapies that are both effective and cost-effective is paramount. The present analysis assessed the cost-effectiveness of onceweekly semaglutide 0.5 mg and 1 mg versus once-weekly dulaglutide 1.5 mg and versus once daily sitagliptin 100 mg for the treatment of patients with type 2 diabetes with inadequate glycemic control on oral anti-hyperglycemic medications over patient lifetimes from a healthcare payer perspective in the Spanish setting. Methods: Cost and clinical outcomes were projected over patient lifetimes using the IQVIA CORE Diabetes Model. Baseline cohort characteristics and treatment effects on initiation of semaglutide 0.5 mg and 1 mg, dulaglutide 1.5 mg and sitagliptin 100 mg were based on the once-weekly semaglutide clinical trial program (SUSTAIN 7 and 2). Captured costs included treatment costs and costs of diabetesrelated complications. Projected outcomes were discounted at 3.0% annually. Results: Projections of long-term clinical outcomes indicated that once-weekly semaglutide 0.5 mg and 1 mg were associated with improvements in discounted life expectancy of 0.02 and 0.11 years, respectively, and discounted quality-adjusted life expectancy of 0.03 and 0.11 quality-adjusted life years (QALYs), respectively, versus dulaglutide 1.5 mg. Compared with sitagliptin, once-weekly semaglutide 0.5 mg and 1 mg were associated with improvements in discounted life expectancy of 0.17 and 0.24 years, respectively and discounted quality-adjusted life expectancy of 0.16 and 0.23 QALYs. The increased duration and quality of life with once-weekly semaglutide 0.5 mg and 1 mg resulted from a reduced cumulative Digital Features To view digital features for this article go to

OBJECTIVES: To assess the short-term cost-effectiveness of switching to Insulin degludec (degludec) from current basal insulin treatment in Japanese patients with type 2 diabetes (T2DM) on basal bolus (B/B) therapy, using Japanese real world evidence (RWE) data from a prospective observational study. METHODS: A previously published transparent open-source model in Excel was used to assess the short-term cost-effectiveness, in terms of cost per quality-adjusted life year (QALY), over a 1-year period after switching patients to degludec from their current basal insulin in their B/B treatment. Model input data for incidence of hypoglycemia and insulin doses were obtained from a Japanese prospective observational study to estimate the cost per QALY. Model inputs and assumptions related to hypoglycemia outcomes, treatment costs and utility related to dosing flexibility were varied and assessed in sensitivity analyses. Baseline data from the RWE study were used to make the comparison with the patients switching to degludec. RESULTS: In the base case scenario, and across all sensitivity analyses, switching patients to degludec from their current basal insulin was found to be a costeffective intervention. Incremental costs over 1 year in the base case was JPY 9510 with an associated QALY gain of 0.0354, resulting in an incremental cost-effectiveness ratio (ICER) of JPY 268,811 per QALY gained. The ICERs across the sensitivity analyses were all well below the willingness-to-pay (WTP) threshold of JPY 5 million that has been used in the health technology assessment (HTA) pilot in Japan. CONCLUSIONS: Based on Japanese RWE data, switching T2DM patients on B/B therapy from their current basal insulin to degludec was found to be highly cost-effective in a Japanese setting. These findings may inform decision makers in Japan to make cost-effective treatment decisions. PDB65OBJECTIVES: We aimed to systematically identify and appraise cost-effectiveness studies of metformin in high-risk prediabetic subjects. METHODS: A systematic literature review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The search was conducted via different bibliographic databases: PubMed, Embase, ISPOR presentation database as well as the CEA and CRD registries. All cost-effectiveness studies assessing metformin in prediabetic patients were included. We extracted study identification items, interventions, and target population, model design & reported outcomes. The quality of the included studies was assessed using a published critical appraisal checklist for published economic evaluation. RESULTS: After the full-text screening, 16 English-language reports (13 full-text studies and 3 abstracts) fulfilled the eligibility criteria and were included in a qualitative analysis. All models investigated the clinical and economic value of the immediate-release metformin formulation evaluated during the Diabetes Prevention Program (DPP) study. Although, in the long term, metformin ...

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