Semaglutide versus tirzepatide for people with type 2 diabetes: cost of glycemic control in Austria, the Netherlands, Lithuania, and the United Arab Emirates

Abstract

Objectives

The glucagon-like peptide-1 agonist semaglutide and the dual glucose-dependent insulinotropic polypeptide tirzepatide have proven to significantly reduce glucose levels in people with type 2 diabetes. However, the costs needed to achieve a sustained decrease in HbA1c level and disease control with semaglutide and tirzepatide, respectively, are unclear. Therefore, this study aimed to compare the cost of treatment with semaglutide with the cost of treatment with tirzepatide for type 2 diabetes in Austria, the Netherlands, Lithuania, and the United Arab Emirates in order to determine their respective value for money.

Methods

The primary outcome of this analysis was the cost in euros needed to achieve disease control in one person with type 2 diabetes based on the composite endpoint of HbA1c <7%, ≥5% weight loss, and no hypoglycemic events. In addition, analyses regarding the cost needed to reach relevant HbA1c endpoints were performed. Clinical data were obtained from the SURPASS 2 trial, registered at clinicaltrials.gov (NCT03987919), and drug cost was based on wholesale acquisition cost or pharmacy purchase prices from public domains obtained in Q1 of 2023.

Results

The cost needed to achieve disease control in one person with type 2 diabetes (HbA1c <7%, ≥5% weight loss, and no hypoglycemic events) was up to three times lower using semaglutide compared with all three doses of tirzepatide in most markets. In the HbA1c analyses, semaglutide was also found to be the least expensive treatment option.

Conclusion

Semaglutide provides better value for money than tirzepatide for HbA1c-lowering endpoints.

Keywords:

• Diabetes mellitus
• type 2
• treatment cost
• glycemic control
• cost of control

Transparency

Declaration of funding

The analysis presented in this article and manuscript writing was supported by Novo Nordisk North West Europe. Novo Nordisk reviewed and provided feedback on the manuscript.

Declaration of financial/other relationships

Hongye Ren, Olga Barszczewska, and Amaury Basse are employees of Novo Nordisk A/S. Signe Baattrup Reitzel and Mette Bøgelund are employees of EY Denmark, which is a paid vendor of Novo Nordisk A/S. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Mette Bøgelund, Amaury Basse, Olga Barszczewska and Hongye Ren were involved in conceptualizing and designing the study. Signe Baattrup Reitzel analyzed and interpreted the data and drafted the paper. All authors critically revised the paper and gave final approval for the version to be published. All authors agree to be accountable for the work presented in this paper.

Acknowledgements

No assistance in the preparation of this article is to be declared.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and/or its supplementary materials.

Ethics statements

Results from the SURPASS 2 trial (NCT03987919) were applied in this study.