The long-term cost-effectiveness of oral semaglutide in the Netherlands based on the PIONEER 2, 3 and 4 randomized controlled trials

AimsTo assess the long-term cost-effectiveness of novel glucagon-like peptide-1 (GLP-1) analog oral semaglutide versus sodium-glucose cotransporter-2 inhibitor empagliflozin, dipeptidyl peptidase-4 sitagliptin and injectable GLP-1 liraglutide in Netherlands, based on results PIONEER clinical trials.MethodsOutcomes were projected over patient lifetimes using IQVIA CORE Diabetes Model. Clinical data derived from 2, 3 4. Patients assumed to receive initial treatments until glycated hemoglobin exceeded 7.5%, then treatment-intensified basal insulin therapy. Costs accounted a societal perspective 2019 euros (EUR).ResultsOral 14 mg was associated with improvements quality-adjusted life expectancy 0.15, 0.22 0.09 years (QALYs) empagliflozin 25 mg, 100 1.8 respectively, combined costs EUR 1,032 higher, 115 higher 1,267 lower. Oral therefore incremental ratios 7,061 516 per QALY gained sitagliptin, respectively.ConclusionsBased projections, considered cost-effective dominant for treatment type 2 diabetes Netherlands.