Cost-utility analysis of semaglutide versus canagliflozin in patients with type 2 diabetes poorly controlled with metformin

XU Yueru; WANG Yubo; PAN Huimin; SHAN Huiting; CHEN Ji; YANG Jianhua

doi:10.6039/j.issn.1001-0408.2025.09.12

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Cost-utility analysis of semaglutide versus canagliflozin in patients with type 2 diabetes poorly controlled with metformin

更新时间：2025-05-09

- Cost-utility analysis of semaglutide versus canagliflozin in patients with type 2 diabetes poorly controlled with metformin
- ZHONGGUO YAOFANG Vol. 36, Issue 9, Pages: 1087-1092(2025)
- 作者机构：
  
  1.新疆医科大学药学院，乌鲁木齐　830011
  2.新疆医科大学第一附属医院药学部，乌鲁木齐　830011
  3.新疆药物临床研究重点实验室，乌鲁木齐　830011
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.09.12
  CLC： R956
- Received：14 October 2024，
  
  Revised：11 April 2025，
  
  Accepted：2025-04-14，
  
  Published：15 May 2025
- 稿件说明：
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徐跃洳,王钰博,潘慧敏等.司美格鲁肽对比卡格列净治疗二甲双胍控制不佳的2型糖尿病患者的成本-效用分析 ^Δ[J].中国药房,2025,36(09):1087-1092.

XU Yueru,WANG Yubo,PAN Huimin,et al.Cost-utility analysis of semaglutide versus canagliflozin in patients with type 2 diabetes poorly controlled with metformin[J].ZHONGGUO YAOFANG,2025,36(09):1087-1092.
徐跃洳,王钰博,潘慧敏等.司美格鲁肽对比卡格列净治疗二甲双胍控制不佳的2型糖尿病患者的成本-效用分析 ^Δ[J].中国药房,2025,36(09):1087-1092. DOI： 10.6039/j.issn.1001-0408.2025.09.12.

XU Yueru,WANG Yubo,PAN Huimin,et al.Cost-utility analysis of semaglutide versus canagliflozin in patients with type 2 diabetes poorly controlled with metformin[J].ZHONGGUO YAOFANG,2025,36(09):1087-1092. DOI： 10.6039/j.issn.1001-0408.2025.09.12.

摘要

目的

对二甲双胍控制不佳的2型糖尿病（T2DM）患者使用卡格列净或司美格鲁肽治疗的长期经济性进行评价。

方法

从我国卫生体系角度出发，构建Markov模型，基于SUSTAIN 8研究数据模拟我国T2DM患者在二甲双胍基础上联用卡格列净或司美格鲁肽治疗30年的长期成本和效用，并以2024年我国人均国内生产总值（GDP）的1倍作为意愿支付（WTP）阈值计算增量成本-效果比（ICER）和增量净货币收益（INMB）。通过单因素敏感性分析、概率敏感性分析以及情境分析确认基础分析结论的稳定性。

结果

与卡格列净+二甲双胍方案相比，司美格鲁肽+二甲双胍方案的ICER为260 485.67元/质量调整生命年（QALY），大于本研究设定的WTP阈值（95 749元/QALY），INMB为－61 576.24元，卡格列净+二甲双胍方案更具经济性优势。司美格鲁肽+二甲双胍方案组糖尿病无并发症治疗成本对INMB的影响最大，但参数在选定范围内的变动不会驱动结果发生逆转。随着WTP阈值的增加，司美格鲁肽+二甲双胍方案在经济性上的可接受概率呈上升趋势。在当前WTP阈值下，司美格鲁肽的年成本需下降42.95%，司美格鲁肽+二甲双胍方案才能成为更具经济性优势的方案。

结论

从中国卫生体系角度出发，对于单用二甲双胍血糖控制不佳的T2DM患者，卡格列净+二甲双胍方案相较于司美格鲁肽+二甲双胍方案更具经济性优势。

Abstract

OBJECTIVE

To evaluate the long-term cost-effectiveness of canagliflozin or semaglutide in patients with type 2 diabetes mellitus（T2DM）poorly controlled with metformin.

METHODS

Based on the perspective of China’s health system， a Markov model was used to calculate the long-term costs and utilities of canagliflozin or semaglutide combined with metformin for T2DM patients in China for 30 years based on the data from SUSTAIN 8 study. The incremental cost-effectiveness ratio（ICER） and incremental net monetary benefit （INMB） were calculated using one time the 2024 per capita gross domestic product（GDP） as the willingness-to-pay（WTP） threshold. One-way sensitivity analysis， probability sensitivity analysis and scenario analysis were conducted to confirm the stability of the conclusions.

RESULTS

Compared with canagliflozin + metformin， ICER of semaglutide combined with metformin was 260 485.67 yuan/quality-adjusted life year （QALY），which was higher than the WTP threshold set in this study （95 749 yuan/QALY），and the corresponding INMB was －61 576.24 yuan，indicating that the canagliflozin + metformin regimen was more cost-effective. The cost of diabetes without complications treatment in the semaglutide + metformin group had the greatest influence on INMB，but changes in parameters within the selected range did not drive decision reversal. With the increasing of WTP threshold，the economic acceptability of semaglutide + metformin regimen increased. Under the current WTP threshold，the annual cost of semaglutide should be reduced by 42.95% to make the semaglutide + metformin regimen more cost-effective.

CONCLUSIONS

From the perspective of China’s health system， canagliflozin + metformin is more cost-effective than semaglutide + metformin for T2DM patients with poor glycemic control with metformin alone.

关键词

Keywords

references

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