Oral semaglutide versus injectable glucagon-like peptide-1 receptor agonists: a cost of control analysis

Figures & data

Table 1. Estimated proportion of patients achieving treatment targets.

	HbA1c ≤ 6.5%	HbA1c < 7.0%
Oral semaglutide 14 mg QD	54.1% (37.9–69.9%)	69.7% (55.6–81.3%)
Dulaglutide 1.5 mg QW	49.0% (35.2–63.5%)	64.7% (51.9–75.9%)
Exenatide 2 mg QW	42.0% (27.8–57.1%)	60.7% (47.6–72.2%)
Exenatide 10 µg BID	29.2% (18.3–43.7%)	44.7% (31.3–59.2%)
Liraglutide 1.8 mg QD	45.8% (33.9–58.3%)	64.6% (53.5–74.4%)
Lixisenatide 20 µg QD	23.5% (15.9–33.7%)	41.1% (31.0–51.9%)
Semaglutide 1 mg QW	65.3% (50.4–77.5%)	79.8% (69.3–87.4%)

Values are estimated medians (lower and upper 95% credible interval)¹⁶. Abbreviations. BID, twice daily; HbA1c, glycated hemoglobin; QD, once daily; QW, once weekly.

Table 2. Wholesale acquisition cost applied in the analysis.

Medication	Pack contents	Days per pack	Pack price (USD)
Oral semaglutide 14 mg QD	420.0 mg	30	772.43
Dulaglutide 1.5 mg QW	6.0 mg	28	759.40
Exenatide 2 mg QW	8.0 mg	28	699.77
Exenatide 10 µg BID	600.0 mg	30	729.63
Liraglutide 1.8 mg QD	54.0 mg	30	921.78
Lixisenatide 20 µg QD	560.0 mg	28	620.18
Semaglutide 1 mg QW	4.0 mg	28	772.43
Needles for injection of liraglutide (NovoFine 30G)	100 needles	–	39.41
Needles for injection of lixisenatide 20 µg QD and exenatide 10 µg BID (BD MicroFine+™ 5mm/31G)	500 needles	–	123.25

Costs taken from the IBM Micromedex. RED BOOK in September 2019²⁷. Abbreviations. BID, twice daily; QD, once daily; QW, once weekly; USD, 2019 United States dollars.

Figure 1. Annual cost of treatment. Abbreviations. BID, twice daily; QD, once daily; QW, once weekly; USD, 2019 United States dollars.

Figure 2. Number needed to treat to bring one patient to target. Abbreviations. BID, twice daily; HbA1c, glycated hemoglobin; QD, once daily; QW, once weekly.

Figure 3. Cost of control. Abbreviations. BID, twice daily; HbA1c, glycated hemoglobin; QD, once daily; QW, once weekly; USD, 2019 United States dollars.

Table 3. Results of the probabilistic sensitivity analysis.

	Cost of control (USD)
	HbA1c ≤ 6.5%	HbA1c < 7.0%
Oral semaglutide 14 mg QD	17,791 (2,820)	13,587 (1,333)
Dulaglutide 1.5 mg QW	20,727 (3,165)	15,490 (1,466)
Exenatide 2 mg QW	22,621 (4,897)	15,161 (1,624)
Exenatide 10 µg BID	33,065 (10,425)	20,695 (3,590)
Liraglutide 1.8 mg QD	25,468 (3,653)	17,733 (1,455)
Lixisenatide 20 µg QD	36,552 (8,293)	20,232 (2,640)
Semaglutide 1 mg QW	15,651 (1,726)	12,653 (707)

Values are mean (standard deviation). Abbreviations. BID, twice daily; HbA1c, glycated hemoglobin; QD, once daily; QW, once weekly; USD, 2019 United States dollars.

Nuhoho S, Gupta J, Hansen BB, et al. Orally administered semaglutide versus GLP-1 RAs in patients with type 2 diabetes previously receiving 1-2 oral antidiabetics: systematic review and network meta-analysis. Diabetes Ther. 2019;10(6):2183–2199.

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IBM Micromedex. RED BOOK. [cited 2019 Sep 30]. Available from: https://www.micromedexsolutions.com/home/dispatch.

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Data availability statement

All data used in the analysis are included in the manuscript.