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Budget Impact of Oral Semaglutide Intensification versus Sitagliptin among US Patients with Type 2 Diabetes Mellitus Uncontrolled with Metformin
Background Oral semaglutide was approved in 2019 for blood glucose control in patients with type 2 diabetes mellitus (T2DM) and was the first oral glucagon-like peptide 1 receptor agonist (GLP-1 RA). T2DM is associated with substantial healthcare expenditures in the US, so the cost of a new interven...
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Published in: | PharmacoEconomics 2021-03, Vol.39 (3), p.317-330 |
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creator | Wehler, Elizabeth Lautsch, Dominik Kowal, Stacey Davies, Glenn Briggs, Andrew Li, Qianyi Rajpathak, Swapnil Alsumali, Adnan |
description | Background
Oral semaglutide was approved in 2019 for blood glucose control in patients with type 2 diabetes mellitus (T2DM) and was the first oral glucagon-like peptide 1 receptor agonist (GLP-1 RA). T2DM is associated with substantial healthcare expenditures in the US, so the cost of a new intervention should be weighed against clinical benefits.
Objective
This study evaluated the budget impact of a treatment pathway with oral semaglutide 14 mg daily versus oral sitagliptin 100 mg daily among patients not achieving target glycated hemoglobin (HbA1c) level despite treatment with metformin.
Methods
This study used the validated IQVIA™ CORE Diabetes Model to simulate the treatment impact of oral semaglutide 14 mg and sitagliptin 100 mg over a 5-year time horizon from a US healthcare sector (payer) perspective. Trial data (PIONEER 3) informed cohort characteristics and treatment effects, and literature sources informed event costs. Population and market share data were from the literature and data on file. The analysis evaluated the estimated budget impact of oral semaglutide 14 mg use for patients currently using sitagliptin 100 mg considering both direct medical and treatment costs to understand the impact on total cost of care, given underlying treatment performance and impact on avoidable events.
Results
In a hypothetical plan of 1 million lives, an estimated 1993 patients were treated with sitagliptin 100 mg in the target population. Following these patients over 5 years, the incremental direct medical and treatment costs of a patient using oral semaglutide 14 mg versus sitagliptin 100 mg was $US16,562, a 70.7% increase (year 2019 values). A hypothetical payer would spend an additional $US3,300,143 (7.1%) over 5 years for every 10% of market share that oral semaglutide 14 mg takes away from sitagliptin 100 mg. Univariate and scenario analyses with alternate inputs and assumptions demonstrated consistent results.
Conclusions
Use of oral semaglutide 14 mg in patients currently receiving sitagliptin 100 mg substantially increases the budget impact for patients with T2DM whose blood glucose level is not controlled with metformin over a 5-year time horizon for US healthcare payers.
Plain Language Summary
Patients with type 2 diabetes mellitus (T2DM) have many treatment options. Choices depend on factors such as cost, preference, and patient characteristics. Oral semaglutide was recently approved for the treatment of T2DM as the first oral therapy of its class |
doi_str_mv | 10.1007/s40273-020-00967-7 |
format | article |
fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7882575</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714603204</galeid><sourcerecordid>A714603204</sourcerecordid><originalsourceid>FETCH-LOGICAL-c541t-880b95a718867a4437ca55c8035ab756f96a6caf563c1f99c16adbfb3b2f159a3</originalsourceid><addsrcrecordid>eNp9ks1u1DAUhSMEoqXwAiyQJTZsUvwT2_EGqS1_I7Uq0nTWluPYqavEHmynqG_BI-NpSksRQlkk8v3Occ7VqarXCB4iCPn71EDMSQ0xrCEUjNf8SbWPEBc1LoOnt9-w5kzAvepFSlcQQkY4fl7tEYIopIztVz-P534wGaymrdIZBAvOoxrB2kxqGOfsegNWPhufnHVaZRc8uDYxzQmsXS6I22bngZqCH8BmDb4VxPicwA-XL8HFzdYADD461ZlsEjgz4-hy0W68Dj7HMI6mX9Azk22Ik_Mvq2dWjcm8unsfVJvPny5Ovtan519WJ0entaYNynXbwk5QxVHbMq6ahnCtKNUtJFR1nDIrmGJaWcqIRlYIjZjqO9uRDltEhSIH1YfFdzt3k-l1-esSXG6jm1S8kUE5-Xji3aUcwrXkbYspp8Xg3Z1BDN9nk7KcXNIlofImzEnihnLBWkGagr79C70Kc_QlXqEEwpRRIh6oQY1GOm9DuVfvTOURRw2DBMOd1-E_qPL0ZnJlq8a6cv5IgBeBjiGlaOx9RgTlrkdy6ZEsPZK3PZK8iN78uZ17ye_iFIAsQCojP5j4EOk_tr8ADJTUlA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2491256539</pqid></control><display><type>article</type><title>Budget Impact of Oral Semaglutide Intensification versus Sitagliptin among US Patients with Type 2 Diabetes Mellitus Uncontrolled with Metformin</title><source>Nexis UK</source><source>ABI/INFORM Global</source><source>Springer Nature</source><creator>Wehler, Elizabeth ; Lautsch, Dominik ; Kowal, Stacey ; Davies, Glenn ; Briggs, Andrew ; Li, Qianyi ; Rajpathak, Swapnil ; Alsumali, Adnan</creator><creatorcontrib>Wehler, Elizabeth ; Lautsch, Dominik ; Kowal, Stacey ; Davies, Glenn ; Briggs, Andrew ; Li, Qianyi ; Rajpathak, Swapnil ; Alsumali, Adnan</creatorcontrib><description>Background
Oral semaglutide was approved in 2019 for blood glucose control in patients with type 2 diabetes mellitus (T2DM) and was the first oral glucagon-like peptide 1 receptor agonist (GLP-1 RA). T2DM is associated with substantial healthcare expenditures in the US, so the cost of a new intervention should be weighed against clinical benefits.
Objective
This study evaluated the budget impact of a treatment pathway with oral semaglutide 14 mg daily versus oral sitagliptin 100 mg daily among patients not achieving target glycated hemoglobin (HbA1c) level despite treatment with metformin.
Methods
This study used the validated IQVIA™ CORE Diabetes Model to simulate the treatment impact of oral semaglutide 14 mg and sitagliptin 100 mg over a 5-year time horizon from a US healthcare sector (payer) perspective. Trial data (PIONEER 3) informed cohort characteristics and treatment effects, and literature sources informed event costs. Population and market share data were from the literature and data on file. The analysis evaluated the estimated budget impact of oral semaglutide 14 mg use for patients currently using sitagliptin 100 mg considering both direct medical and treatment costs to understand the impact on total cost of care, given underlying treatment performance and impact on avoidable events.
Results
In a hypothetical plan of 1 million lives, an estimated 1993 patients were treated with sitagliptin 100 mg in the target population. Following these patients over 5 years, the incremental direct medical and treatment costs of a patient using oral semaglutide 14 mg versus sitagliptin 100 mg was $US16,562, a 70.7% increase (year 2019 values). A hypothetical payer would spend an additional $US3,300,143 (7.1%) over 5 years for every 10% of market share that oral semaglutide 14 mg takes away from sitagliptin 100 mg. Univariate and scenario analyses with alternate inputs and assumptions demonstrated consistent results.
Conclusions
Use of oral semaglutide 14 mg in patients currently receiving sitagliptin 100 mg substantially increases the budget impact for patients with T2DM whose blood glucose level is not controlled with metformin over a 5-year time horizon for US healthcare payers.
Plain Language Summary
Patients with type 2 diabetes mellitus (T2DM) have many treatment options. Choices depend on factors such as cost, preference, and patient characteristics. Oral semaglutide was recently approved for the treatment of T2DM as the first oral therapy of its class. This study estimated the cost for patients treated with sitagliptin 100 mg, a commonly used T2DM treatment, versus oral semaglutide 14 mg for patients whose disease is not well controlled with metformin. Costs and effects were estimated over 5 years for each treatment strategy using predictive model equations and clinical trial data for the two treatments. These costs were considered for both a hypothetical healthcare plan of 1 million lives and the full US population. A patient treated with oral semaglutide 14 mg would expect to see 70.7% higher costs than a patient treated with sitagliptin 100 mg over 5 years. For every 10% of patients who would switch from sitagliptin 100 mg to oral semaglutide 14 mg, costs would increase by 7.1%. Changing the cost of oral semaglutide 14 mg had the greatest impact on model results. The findings from the analysis were consistent across a range of alternate model inputs. Oral semaglutide 14 mg is more costly than sitagliptin 100 mg over 5 years.</description><identifier>ISSN: 1170-7690</identifier><identifier>ISSN: 1179-2027</identifier><identifier>EISSN: 1179-2027</identifier><identifier>DOI: 10.1007/s40273-020-00967-7</identifier><identifier>PMID: 33150566</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Analysis ; Antidiabetics ; Clinical trials ; Costs ; Diabetes ; Diabetes Mellitus, Type 2 - drug therapy ; Dosage and administration ; Drug therapy ; Expenditures ; GLP-1 receptor agonists ; Glucagon ; Glucagon-Like Peptides ; Glucose ; Glycated Hemoglobin - analysis ; Health Administration ; Health care expenditures ; Health care industry ; Health Economics ; Hemoglobin ; Humans ; Hypoglycemia ; Hypoglycemic Agents ; Market shares ; Medical care, Cost of ; Medicine ; Medicine & Public Health ; Metformin ; Original ; Original Research Article ; Patients ; Peptides ; Pharmacoeconomics and Health Outcomes ; Public Health ; Quality of Life Research ; Sitagliptin ; Sitagliptin Phosphate ; Type 2 diabetes</subject><ispartof>PharmacoEconomics, 2021-03, Vol.39 (3), p.317-330</ispartof><rights>The Author(s) 2020</rights><rights>COPYRIGHT 2021 Springer</rights><rights>Copyright Springer Nature B.V. Mar 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-880b95a718867a4437ca55c8035ab756f96a6caf563c1f99c16adbfb3b2f159a3</citedby><cites>FETCH-LOGICAL-c541t-880b95a718867a4437ca55c8035ab756f96a6caf563c1f99c16adbfb3b2f159a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2491256539/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2491256539?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,11688,27924,27925,36060,36061,44363,74895</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33150566$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wehler, Elizabeth</creatorcontrib><creatorcontrib>Lautsch, Dominik</creatorcontrib><creatorcontrib>Kowal, Stacey</creatorcontrib><creatorcontrib>Davies, Glenn</creatorcontrib><creatorcontrib>Briggs, Andrew</creatorcontrib><creatorcontrib>Li, Qianyi</creatorcontrib><creatorcontrib>Rajpathak, Swapnil</creatorcontrib><creatorcontrib>Alsumali, Adnan</creatorcontrib><title>Budget Impact of Oral Semaglutide Intensification versus Sitagliptin among US Patients with Type 2 Diabetes Mellitus Uncontrolled with Metformin</title><title>PharmacoEconomics</title><addtitle>PharmacoEconomics</addtitle><addtitle>Pharmacoeconomics</addtitle><description>Background
Oral semaglutide was approved in 2019 for blood glucose control in patients with type 2 diabetes mellitus (T2DM) and was the first oral glucagon-like peptide 1 receptor agonist (GLP-1 RA). T2DM is associated with substantial healthcare expenditures in the US, so the cost of a new intervention should be weighed against clinical benefits.
Objective
This study evaluated the budget impact of a treatment pathway with oral semaglutide 14 mg daily versus oral sitagliptin 100 mg daily among patients not achieving target glycated hemoglobin (HbA1c) level despite treatment with metformin.
Methods
This study used the validated IQVIA™ CORE Diabetes Model to simulate the treatment impact of oral semaglutide 14 mg and sitagliptin 100 mg over a 5-year time horizon from a US healthcare sector (payer) perspective. Trial data (PIONEER 3) informed cohort characteristics and treatment effects, and literature sources informed event costs. Population and market share data were from the literature and data on file. The analysis evaluated the estimated budget impact of oral semaglutide 14 mg use for patients currently using sitagliptin 100 mg considering both direct medical and treatment costs to understand the impact on total cost of care, given underlying treatment performance and impact on avoidable events.
Results
In a hypothetical plan of 1 million lives, an estimated 1993 patients were treated with sitagliptin 100 mg in the target population. Following these patients over 5 years, the incremental direct medical and treatment costs of a patient using oral semaglutide 14 mg versus sitagliptin 100 mg was $US16,562, a 70.7% increase (year 2019 values). A hypothetical payer would spend an additional $US3,300,143 (7.1%) over 5 years for every 10% of market share that oral semaglutide 14 mg takes away from sitagliptin 100 mg. Univariate and scenario analyses with alternate inputs and assumptions demonstrated consistent results.
Conclusions
Use of oral semaglutide 14 mg in patients currently receiving sitagliptin 100 mg substantially increases the budget impact for patients with T2DM whose blood glucose level is not controlled with metformin over a 5-year time horizon for US healthcare payers.
Plain Language Summary
Patients with type 2 diabetes mellitus (T2DM) have many treatment options. Choices depend on factors such as cost, preference, and patient characteristics. Oral semaglutide was recently approved for the treatment of T2DM as the first oral therapy of its class. This study estimated the cost for patients treated with sitagliptin 100 mg, a commonly used T2DM treatment, versus oral semaglutide 14 mg for patients whose disease is not well controlled with metformin. Costs and effects were estimated over 5 years for each treatment strategy using predictive model equations and clinical trial data for the two treatments. These costs were considered for both a hypothetical healthcare plan of 1 million lives and the full US population. A patient treated with oral semaglutide 14 mg would expect to see 70.7% higher costs than a patient treated with sitagliptin 100 mg over 5 years. For every 10% of patients who would switch from sitagliptin 100 mg to oral semaglutide 14 mg, costs would increase by 7.1%. Changing the cost of oral semaglutide 14 mg had the greatest impact on model results. The findings from the analysis were consistent across a range of alternate model inputs. Oral semaglutide 14 mg is more costly than sitagliptin 100 mg over 5 years.</description><subject>Analysis</subject><subject>Antidiabetics</subject><subject>Clinical trials</subject><subject>Costs</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Expenditures</subject><subject>GLP-1 receptor agonists</subject><subject>Glucagon</subject><subject>Glucagon-Like Peptides</subject><subject>Glucose</subject><subject>Glycated Hemoglobin - analysis</subject><subject>Health Administration</subject><subject>Health care expenditures</subject><subject>Health care industry</subject><subject>Health Economics</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hypoglycemia</subject><subject>Hypoglycemic Agents</subject><subject>Market shares</subject><subject>Medical care, Cost of</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metformin</subject><subject>Original</subject><subject>Original Research Article</subject><subject>Patients</subject><subject>Peptides</subject><subject>Pharmacoeconomics and Health Outcomes</subject><subject>Public Health</subject><subject>Quality of Life Research</subject><subject>Sitagliptin</subject><subject>Sitagliptin Phosphate</subject><subject>Type 2 diabetes</subject><issn>1170-7690</issn><issn>1179-2027</issn><issn>1179-2027</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>M0C</sourceid><recordid>eNp9ks1u1DAUhSMEoqXwAiyQJTZsUvwT2_EGqS1_I7Uq0nTWluPYqavEHmynqG_BI-NpSksRQlkk8v3Occ7VqarXCB4iCPn71EDMSQ0xrCEUjNf8SbWPEBc1LoOnt9-w5kzAvepFSlcQQkY4fl7tEYIopIztVz-P534wGaymrdIZBAvOoxrB2kxqGOfsegNWPhufnHVaZRc8uDYxzQmsXS6I22bngZqCH8BmDb4VxPicwA-XL8HFzdYADD461ZlsEjgz4-hy0W68Dj7HMI6mX9Azk22Ik_Mvq2dWjcm8unsfVJvPny5Ovtan519WJ0entaYNynXbwk5QxVHbMq6ahnCtKNUtJFR1nDIrmGJaWcqIRlYIjZjqO9uRDltEhSIH1YfFdzt3k-l1-esSXG6jm1S8kUE5-Xji3aUcwrXkbYspp8Xg3Z1BDN9nk7KcXNIlofImzEnihnLBWkGagr79C70Kc_QlXqEEwpRRIh6oQY1GOm9DuVfvTOURRw2DBMOd1-E_qPL0ZnJlq8a6cv5IgBeBjiGlaOx9RgTlrkdy6ZEsPZK3PZK8iN78uZ17ye_iFIAsQCojP5j4EOk_tr8ADJTUlA</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Wehler, Elizabeth</creator><creator>Lautsch, Dominik</creator><creator>Kowal, Stacey</creator><creator>Davies, Glenn</creator><creator>Briggs, Andrew</creator><creator>Li, Qianyi</creator><creator>Rajpathak, Swapnil</creator><creator>Alsumali, Adnan</creator><general>Springer International Publishing</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0U~</scope><scope>1-H</scope><scope>3V.</scope><scope>4T-</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K60</scope><scope>K6~</scope><scope>K9.</scope><scope>L.-</scope><scope>L.0</scope><scope>M0C</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210301</creationdate><title>Budget Impact of Oral Semaglutide Intensification versus Sitagliptin among US Patients with Type 2 Diabetes Mellitus Uncontrolled with Metformin</title><author>Wehler, Elizabeth ; Lautsch, Dominik ; Kowal, Stacey ; Davies, Glenn ; Briggs, Andrew ; Li, Qianyi ; Rajpathak, Swapnil ; Alsumali, Adnan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-880b95a718867a4437ca55c8035ab756f96a6caf563c1f99c16adbfb3b2f159a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Analysis</topic><topic>Antidiabetics</topic><topic>Clinical trials</topic><topic>Costs</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Expenditures</topic><topic>GLP-1 receptor agonists</topic><topic>Glucagon</topic><topic>Glucagon-Like Peptides</topic><topic>Glucose</topic><topic>Glycated Hemoglobin - analysis</topic><topic>Health Administration</topic><topic>Health care expenditures</topic><topic>Health care industry</topic><topic>Health Economics</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hypoglycemia</topic><topic>Hypoglycemic Agents</topic><topic>Market shares</topic><topic>Medical care, Cost of</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metformin</topic><topic>Original</topic><topic>Original Research Article</topic><topic>Patients</topic><topic>Peptides</topic><topic>Pharmacoeconomics and Health Outcomes</topic><topic>Public Health</topic><topic>Quality of Life Research</topic><topic>Sitagliptin</topic><topic>Sitagliptin Phosphate</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wehler, Elizabeth</creatorcontrib><creatorcontrib>Lautsch, Dominik</creatorcontrib><creatorcontrib>Kowal, Stacey</creatorcontrib><creatorcontrib>Davies, Glenn</creatorcontrib><creatorcontrib>Briggs, Andrew</creatorcontrib><creatorcontrib>Li, Qianyi</creatorcontrib><creatorcontrib>Rajpathak, Swapnil</creatorcontrib><creatorcontrib>Alsumali, Adnan</creatorcontrib><collection>Springer Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Global News & ABI/Inform Professional</collection><collection>Trade PRO</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>ABI/INFORM Collection (ProQuest)</collection><collection>ABI/INFORM Global (PDF only)</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Public Health Database (Proquest)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest Business Premium Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Business Premium Collection (Alumni)</collection><collection>Health Research Premium Collection</collection><collection>ABI/INFORM Global (Corporate)</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Business Collection (Alumni Edition)</collection><collection>ProQuest Business Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ABI/INFORM Professional Advanced</collection><collection>ABI/INFORM Professional Standard</collection><collection>ABI/INFORM Global</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Health Management Database (Proquest)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database (ProQuest)</collection><collection>ProQuest One Business</collection><collection>ProQuest One Business (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>PharmacoEconomics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wehler, Elizabeth</au><au>Lautsch, Dominik</au><au>Kowal, Stacey</au><au>Davies, Glenn</au><au>Briggs, Andrew</au><au>Li, Qianyi</au><au>Rajpathak, Swapnil</au><au>Alsumali, Adnan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Budget Impact of Oral Semaglutide Intensification versus Sitagliptin among US Patients with Type 2 Diabetes Mellitus Uncontrolled with Metformin</atitle><jtitle>PharmacoEconomics</jtitle><stitle>PharmacoEconomics</stitle><addtitle>Pharmacoeconomics</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>39</volume><issue>3</issue><spage>317</spage><epage>330</epage><pages>317-330</pages><issn>1170-7690</issn><issn>1179-2027</issn><eissn>1179-2027</eissn><abstract>Background
Oral semaglutide was approved in 2019 for blood glucose control in patients with type 2 diabetes mellitus (T2DM) and was the first oral glucagon-like peptide 1 receptor agonist (GLP-1 RA). T2DM is associated with substantial healthcare expenditures in the US, so the cost of a new intervention should be weighed against clinical benefits.
Objective
This study evaluated the budget impact of a treatment pathway with oral semaglutide 14 mg daily versus oral sitagliptin 100 mg daily among patients not achieving target glycated hemoglobin (HbA1c) level despite treatment with metformin.
Methods
This study used the validated IQVIA™ CORE Diabetes Model to simulate the treatment impact of oral semaglutide 14 mg and sitagliptin 100 mg over a 5-year time horizon from a US healthcare sector (payer) perspective. Trial data (PIONEER 3) informed cohort characteristics and treatment effects, and literature sources informed event costs. Population and market share data were from the literature and data on file. The analysis evaluated the estimated budget impact of oral semaglutide 14 mg use for patients currently using sitagliptin 100 mg considering both direct medical and treatment costs to understand the impact on total cost of care, given underlying treatment performance and impact on avoidable events.
Results
In a hypothetical plan of 1 million lives, an estimated 1993 patients were treated with sitagliptin 100 mg in the target population. Following these patients over 5 years, the incremental direct medical and treatment costs of a patient using oral semaglutide 14 mg versus sitagliptin 100 mg was $US16,562, a 70.7% increase (year 2019 values). A hypothetical payer would spend an additional $US3,300,143 (7.1%) over 5 years for every 10% of market share that oral semaglutide 14 mg takes away from sitagliptin 100 mg. Univariate and scenario analyses with alternate inputs and assumptions demonstrated consistent results.
Conclusions
Use of oral semaglutide 14 mg in patients currently receiving sitagliptin 100 mg substantially increases the budget impact for patients with T2DM whose blood glucose level is not controlled with metformin over a 5-year time horizon for US healthcare payers.
Plain Language Summary
Patients with type 2 diabetes mellitus (T2DM) have many treatment options. Choices depend on factors such as cost, preference, and patient characteristics. Oral semaglutide was recently approved for the treatment of T2DM as the first oral therapy of its class. This study estimated the cost for patients treated with sitagliptin 100 mg, a commonly used T2DM treatment, versus oral semaglutide 14 mg for patients whose disease is not well controlled with metformin. Costs and effects were estimated over 5 years for each treatment strategy using predictive model equations and clinical trial data for the two treatments. These costs were considered for both a hypothetical healthcare plan of 1 million lives and the full US population. A patient treated with oral semaglutide 14 mg would expect to see 70.7% higher costs than a patient treated with sitagliptin 100 mg over 5 years. For every 10% of patients who would switch from sitagliptin 100 mg to oral semaglutide 14 mg, costs would increase by 7.1%. Changing the cost of oral semaglutide 14 mg had the greatest impact on model results. The findings from the analysis were consistent across a range of alternate model inputs. Oral semaglutide 14 mg is more costly than sitagliptin 100 mg over 5 years.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33150566</pmid><doi>10.1007/s40273-020-00967-7</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1170-7690 |
ispartof | PharmacoEconomics, 2021-03, Vol.39 (3), p.317-330 |
issn | 1170-7690 1179-2027 1179-2027 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7882575 |
source | Nexis UK; ABI/INFORM Global; Springer Nature |
subjects | Analysis Antidiabetics Clinical trials Costs Diabetes Diabetes Mellitus, Type 2 - drug therapy Dosage and administration Drug therapy Expenditures GLP-1 receptor agonists Glucagon Glucagon-Like Peptides Glucose Glycated Hemoglobin - analysis Health Administration Health care expenditures Health care industry Health Economics Hemoglobin Humans Hypoglycemia Hypoglycemic Agents Market shares Medical care, Cost of Medicine Medicine & Public Health Metformin Original Original Research Article Patients Peptides Pharmacoeconomics and Health Outcomes Public Health Quality of Life Research Sitagliptin Sitagliptin Phosphate Type 2 diabetes |
title | Budget Impact of Oral Semaglutide Intensification versus Sitagliptin among US Patients with Type 2 Diabetes Mellitus Uncontrolled with Metformin |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T17%3A45%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Budget%20Impact%20of%20Oral%20Semaglutide%20Intensification%20versus%20Sitagliptin%20among%20US%20Patients%20with%20Type%202%20Diabetes%20Mellitus%20Uncontrolled%20with%20Metformin&rft.jtitle=PharmacoEconomics&rft.au=Wehler,%20Elizabeth&rft.date=2021-03-01&rft.volume=39&rft.issue=3&rft.spage=317&rft.epage=330&rft.pages=317-330&rft.issn=1170-7690&rft.eissn=1179-2027&rft_id=info:doi/10.1007/s40273-020-00967-7&rft_dat=%3Cgale_pubme%3EA714603204%3C/gale_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c541t-880b95a718867a4437ca55c8035ab756f96a6caf563c1f99c16adbfb3b2f159a3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2491256539&rft_id=info:pmid/33150566&rft_galeid=A714603204&rfr_iscdi=true |