Usefulness of Empagliflozin Versus Oral Semaglutide for Prevention of Cardiovascular Mortality in Patients With Type 2 Diabetes Mellitus

• Published in: The American journal of cardiology 2022-05, Vol.170, p.128-131
• Main Authors: Hammerman, Ariel, Moore, Candace Makeda, Aboalhasan, Enis, Azuri, Joseph, Arbel, Ronen
• Format: Article
• Language: English
• Subjects: Antidiabetics; Benzhydryl Compounds; Blood pressure; Cardiovascular diseases; Cardiovascular Diseases - drug therapy; Cardiovascular Diseases - prevention & control; Clinical trials; Confidence intervals; Cost analysis; Cost control; Costs; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Glucagon-Like Peptides; Glucosides; Humans; Hypoglycemic Agents - therapeutic use; Mathematical analysis; Mortality; Patients; Prevention; Stroke; United States - epidemiology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2022.01.027

Empagliflozin and oral semaglutide reduce the incidence of cardiovascular mortality (CVM) in patients with type 2 diabetes mellitus. However, these therapies impose a significant financial burden on healthcare systems. Therefore, we compared the value for money of empagliflozin versus oral semaglutide to prevent CVM. We calculated the cost needed to treat to prevent 1 case of CVM using either drug by multiplying the annualized number needed to treat to prevent 1 event by the annual cost of the therapy. Efficacy estimates were extracted from published randomized controlled trials data. We performed a scenario analysis to mitigate the primary differences between the populations of randomized controlled trials. Drug costs were calculated as 75% of the United States National Average Drug Acquisition Cost listing. The annualized number needed to treat for empagliflozin in EMPA-REG-OUTCOME was 141 (95% confidence interval [CI] 104 to 230) and 141 (95% CI 96 to 879) for oral semaglutide in PIONEER 6. The annual treatment costs are $4,797 for empagliflozin versus $7,133 for oral semaglutide. Therefore, the corresponding costs needed to treat are $676,385 ($498,894-$1,101,039) and $1,005,855 (95% CI $684,837-$6,270,544) respectively. In conclusion, our findings suggest that empagliflozin provides better value for money than oral semaglutide to prevent CVM in patients with type 2 diabetes mellitus at the current United States prices of the interventions.