Cost-Control Analysis: Semaglutide versus Sitagliptin and Dulaglutide

Patients with type 2 diabetes have different treatment options to help them achieve target glycated hemoglobin A1c (HbA1c) levels, control body weight, and prevent hypoglycemic events. Previous studies—the Spain-based SUSTAIN 2 and 7 clinical trials—observed that once-weekly semaglutide was more effective in reducing HbA1c levels and weight gain compared with sitagliptin and dulaglutide, respectively. A new study examined the short-term cost of control of attaining the three endpoints for patients with type 2 diabetes treated with semaglutide 0.5 mg, semaglutide 1 mg, sitagliptin, and dulaglutide.

Patients were recruited from SUSTAIN 2 and 7 studies if they achieved HbA1c <7.0%, HbA1c <7.0% without hypoglycemia and without weight gain, and a ≥1.0% HbA1c reduction with ≥5.0% weight loss. The researchers determined the cost of control by dividing the annual per patient cost of each medication by the proportion of patients who attained each endpoint. Costs were assessed in 2019 euros (EUR).

Separate analyses were performed using SUSTAIN 2 and 7 data. In the SUSTAIN 2 arm, the cost of control was lower for sitagliptin for the HbA1c <7.0% endpoint; patients taking both doses of semaglutide had lower costs of control for the ≥1.0% HbA1c reduction with ≥5.0% weight loss endpoint. Outcomes did not largely differ among the groups for the HbA1c <7.0% without hypoglycemia and without weight gain endpoint. In the SUSTAIN 7 arm, costs of control were lower for all three endpoints among patients taking both doses of semaglutide.

The study authors concluded that both semaglutide doses were associated with lower costs of control for the three studied endpoints compared with dulaglutide, and endpoints pertaining to hypoglycemia and costs were either lower or comparable for all three endpoints compared with sitagliptin.