Division of Endocrinology & Metabolism, University of Pittsburgh, PA 15213, USA.
Division of Endocrinology, Veteran's Health Administration Pittsburgh Health System, PA 15240, USA.
J Comp Eff Res. 2021 Oct;10(15):1133-1141. doi: 10.2217/cer-2021-0016. Epub 2021 Sep 7.
Perform a cost-effectiveness analysis of addition of subcutaneous semaglutide versus empagliflozin to usual treatment for patients with Type 2 diabetes and cardiovascular disease in US setting. A Markov decision model estimated the impact of each strategy using cardiovascular complication rates based on EMPA-REG and SUSTAIN-6 trials. Modeled cohorts were followed for 3 years at 1-month intervals beginning at age 66. Compared with empagliflozin, semaglutide resulted in cost of US$19,964 per quality-adjusted life-year gained. In one-way sensitivity analysis, only semaglutide cost >US$36.25/day (base case US$18.04) resulted in empagliflozin being preferred at a willingness-to-pay threshold of US$50,000/quality-adjusted life-year gained. For patients with Type 2 diabetes and cardiovascular disease, semaglutide is likely more cost-effective than empagliflozin added to usual treatment.
在美国环境下，针对患有 2 型糖尿病和心血管疾病的患者，将皮下司美格鲁肽与恩格列净联合常规治疗进行成本效益分析。一项基于 EMPA-REG 和 SUSTAIN-6 试验的心血管并发症率的马克夫决策模型，评估了每种策略的影响。从 66 岁开始，以 1 个月为间隔，对模拟队列进行为期 3 年的随访。与恩格列净相比，司美格鲁肽每增加一个质量调整生命年的成本为 19964 美元。在单因素敏感性分析中，只有当司美格鲁肽的成本超过 36.25 美元/天时（基础案例为 18.04 美元），且愿意支付的阈值为 50000 美元/质量调整生命年时，恩格列净才更具优势。对于患有 2 型糖尿病和心血管疾病的患者，与将恩格列净添加到常规治疗相比，司美格鲁肽可能更具成本效益。
