PMID- 35344191
OWN - NLM
STAT- MEDLINE
DCOM- 20220621
LR  - 20220722
IS  - 1179-1896 (Electronic)
IS  - 1175-5652 (Print)
IS  - 1175-5652 (Linking)
VI  - 20
IP  - 4
DP  - 2022 Jul
TI  - Cost-Effectiveness of Once-Weekly Semaglutide 1 mg versus Canagliflozin 300 mg in 
      Patients with Type 2 Diabetes Mellitus in a Canadian Setting.
PG  - 543-555
LID - 10.1007/s40258-022-00726-z [doi]
AB  - OBJECTIVE: Our objective was to evaluate the long-term cost-effectiveness of 
      once-weekly semaglutide 1 mg versus once-daily canagliflozin 300 mg in patients 
      with type 2 diabetes mellitus (T2DM) uncontrolled with metformin from the 
      healthcare payer and societal perspectives in Canada. METHODS: Head-to-head data 
      from the SUSTAIN 8 randomised trial (NCT03136484) were extrapolated over 40 years 
      using economic simulation modelling. The cost-effectiveness of once-weekly 
      semaglutide 1 mg versus canagliflozin 300 mg for treating T2DM was estimated 
      using the Swedish Institute for Health Economics-Diabetes Cohort Model (IHE-DCM) 
      and the Economic and Health Outcomes Model of T2DM (ECHO-T2DM). Unit costs and 
      disutility weights capturing treatments and key macro- and microvascular 
      complications were sourced from the literature to best match the Canadian 
      setting. A probabilistic base-case simulation and sensitivity analyses were 
      conducted. RESULTS: Once-weekly semaglutide 1 mg was associated with reductions 
      in macro- and microvascular complications, yielding incremental 
      cost-effectiveness ratios (ICERs) of (Canadian dollars [CAD]) CAD16,392 and 
      18,098 per incremental quality-adjusted life-year (QALY) gained versus 
      canagliflozin 300 mg for IHE-DCM and ECHO-T2DM, respectively, from a healthcare 
      payer perspective. Accounting for productivity loss as well, ICERs were CAD14,127 
      and 13,188 per QALY gained for IHE-DCM and ECHO-T2DM, respectively, from a 
      societal perspective. Sensitivity analyses confirmed that the base-case results 
      were robust to changes in input parameters and assumptions used. CONCLUSIONS: At 
      a willingness-to-pay threshold of CAD50,000 per QALY gained, once-weekly 
      semaglutide 1 mg was cost-effective over 40 years versus once-daily canagliflozin 
      300 mg for the treatment of T2DM in patients failing to maintain glycemic control 
      with metformin alone.
CI  - (c) 2022. The Author(s).
FAU - Stafford, Sara
AU  - Stafford S
AUID- ORCID: 0000-0002-1551-6208
AD  - Fraser Health Division of Endocrinology, 902-13737 96th Avenue, Surrey, BC, V3V 
      0C6, Canada. sara.stafford@fraserhealth.ca.
FAU - Bech, Peter G
AU  - Bech PG
AD  - Novo Nordisk Canada Inc., 2476 Argentia Rd, Mississauga, ON, L5N 6M1, Canada.
FAU - Fridhammar, Adam
AU  - Fridhammar A
AD  - The Swedish Institute for Health Economics, Box 2127, 220 02, Lund, Sweden.
FAU - Miresashvili, Nino
AU  - Miresashvili N
AD  - Novo Nordisk A/S, Vandtarnsvej 108, 2860, Soborg, Denmark.
FAU - Nilsson, Andreas
AU  - Nilsson A
AD  - The Swedish Institute for Health Economics, Box 2127, 220 02, Lund, Sweden.
FAU - Willis, Michael
AU  - Willis M
AD  - The Swedish Institute for Health Economics, Box 2127, 220 02, Lund, Sweden.
FAU - Liu, Aiden
AU  - Liu A
AD  - Novo Nordisk Canada Inc., 2476 Argentia Rd, Mississauga, ON, L5N 6M1, Canada.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20220328
PL  - New Zealand
TA  - Appl Health Econ Health Policy
JT  - Applied health economics and health policy
JID - 101150314
RN  - 0 (Hypoglycemic Agents)
RN  - 0SAC974Z85 (Canagliflozin)
RN  - 53AXN4NNHX (semaglutide)
RN  - 62340-29-8 (Glucagon-Like Peptides)
RN  - 9100L32L2N (Metformin)
SB  - IM
EIN - Appl Health Econ Health Policy. 2022 Apr 20;:. PMID: 35441978
MH  - Canada
MH  - Canagliflozin/therapeutic use
MH  - Cost-Benefit Analysis
MH  - *Diabetes Mellitus, Type 2
MH  - Glucagon-Like Peptides
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - *Metformin
MH  - Quality-Adjusted Life Years
PMC - PMC9206917
COIS- SS has received continuing medical education honoraria from Novo Nordisk, 
      Boehringer Ingelheim, Lilly, Sanofi, Janssen, AstraZeneca, Medtronic, Tandem, 
      Abbott, Dexcom, CCRN, CPD Network, and MD Briefcase; participated in advisory 
      boards for Novo Nordisk, Boehringer Ingelheim, Lilly, Sanofi, Janssen, 
      AstraZeneca, and Abbott; and received research support from Sanofi, AstraZeneca, 
      and Novo Nordisk. AL is an employee of Novo Nordisk Canada Inc. PB is an employee 
      and shareholder of Novo Nordisk Canada Inc. AF and AN are employees of, and MW is 
      an employee, minority owner, and unpaid director of the Swedish Institute for 
      Health Economics, which provides consulting services for governmental bodies, 
      academic institutions, and commercial life science enterprises, including Novo 
      Nordisk A/S. The Swedish Institute for Health Economics owns the ECHO-T2DM and 
      IHE-DCM, used in this analysis. The Swedish Institute for Health Economics is 
      owned principally by the non-profit Bengt Jonsson Foundation for Health Economic 
      Research. NM is an employee of Novo Nordisk A/S.
EDAT- 2022/03/29 06:00
MHDA- 2022/06/22 06:00
PMCR- 2022/03/28
CRDT- 2022/03/28 12:17
PHST- 2022/02/27 00:00 [accepted]
PHST- 2022/03/29 06:00 [pubmed]
PHST- 2022/06/22 06:00 [medline]
PHST- 2022/03/28 12:17 [entrez]
PHST- 2022/03/28 00:00 [pmc-release]
AID - 10.1007/s40258-022-00726-z [pii]
AID - 726 [pii]
AID - 10.1007/s40258-022-00726-z [doi]
PST - ppublish
SO  - Appl Health Econ Health Policy. 2022 Jul;20(4):543-555. doi: 
      10.1007/s40258-022-00726-z. Epub 2022 Mar 28.