Long‐term cost‐effectiveness analysis of tirzepatide versus semaglutide 1.0 mg for the management of type 2 diabetes in the United States

Abstract

Aim To evaluate the long‐term cost‐effectiveness of tirzepatide (5, 10 and 15 mg doses), a novel glucose‐dependent insulinotropic polypeptide (GIP) and glucagon‐like peptide‐1 (GLP‐1) receptor agonist, versus semaglutide 1.0 mg, an injectable glucagon‐like peptide‐1 receptor agonist, based on the results of the head‐to‐head SURPASS‐2 trial, from a US healthcare payer perspective. Materials and Methods The PRIME Type 2 Diabetes Model was used to make projections of clinical and cost outcomes over a 50‐year time horizon. Baseline cohort characteristics, treatment effects and adverse event rates were derived from the 40‐week SURPASS‐2 trial. Intensification to insulin therapy occurred when HbA1c reached 7.5%, in line with American Diabetes Association recommendations. Direct costs in 2021 US dollars (US$) and health state utilities were derived from published sources. Future costs and clinical benefits were discounted at 3% annually. Results All three doses of tirzepatide were associated with lower diabetes‐related complication rates, improved life expectancy, improved quality‐adjusted life expectancy and higher direct costs versus semaglutide. This resulted in incremental cost‐effectiveness ratios of US$ 75 803, 58 908 and 48 785 per quality‐adjusted life year gained for tirzepatide 5, 10 and 15 mg, respectively, versus semaglutide. Tirzepatide remained cost‐effective versus semaglutide over a range of sensitivity analyses. Conclusions Long‐term projections based on the SURPASS‐2 trial results indicate that 5, 10 and 15 mg doses of tirzepatide are likely to be cost‐effective versus semaglutide 1.0 mg for the treatment of type 2 diabetes in the United States.

Subcutaneously administered tirzepatide vs semaglutide for adults with type 2 diabetes: a systematic review and network meta-analysis of randomised controlled trials

“…Observational data suggest a notable under-utilisation of GLP-1 RAs among individuals in lower socioeconomic groups, primarily due to the high cost of these medications, highlighting the disparity in access to effective diabetes treatments based on socioeconomic factors [ 63 ]. From a broader societal perspective, even though s.c. tirzepatide has been suggested to be cost-effective compared with s.c. semaglutide in the USA [ 64 ], cost-effectiveness analyses conducted in low-, middle- and high-income countries have demonstrated that GLP-1 RAs are not cost-effective compared with other glucose-lowering drugs [ 63 ].…”

Glycemic Control, Weight Management, Cardiovascular Safety, and Cost-Effectiveness of Semaglutide for Patients with Type 2 Diabetes Mellitus: A Rapid Review and Meta-analysis of Real-World Studies

“…However, multiple MAs of the SURPASS trial program have shown that tirzepatide, in a dose-dependent manner, demonstrates superior glycemic efficacy and noticeable reductions in body weight compared to other GLP-1 RAs, while maintaining a satisfactory safety profile [58][59][60]. In particular, two CEAs have indicated that the 5, 10, and 15 mg doses of tirzepatide are likely to be cost-effective compared to the 1.0 mg dose of semaglutide for the treatment of T2DM in the United States [61,62].…”

Oral glucagon-like peptide-1 receptor agonists and combinations of entero-pancreatic hormones as treatments for adults with type 2 diabetes: where are we now?

“…This may be particularly important in young-onset T2D where higher rates of obesity, more rapid deterioration in blood glucose levels and earlier development of diabetes complications have been observed [ 9 , 95 ]. Nevertheless, the cost-effectiveness of initiating treatment with the novel molecules for T2D in different populations and at different time points during the disease continuum will require further assessment [ 96 ]. The ongoing SURPASS EARLY study will provide over the next years data on the benefits of early tirzepatide initiation (as second line, after metformin) compared to standard care using gradual escalation of glucose-lowering treatments (NCT05433584).…”