Alkhatib Nimer S, Almutairi Abdulaali R, Alkhezi Omar S, Alfayez Osama M, Al Yami Majed S, Almohammed Omar A
Al-Zaytoonah Health Technology Assessment Center (Z-HTA), College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.
Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA.
Saudi Pharm J. 2022 Apr;30(4):433-439. doi: 10.1016/j.jsps.2022.01.018. Epub 2022 Jan 29.
To perform a cost of control analysis of glucagon like peptide-1 receptor agonists (GLP1RA) in Saudi Arabia (SA) and determine the economic impact of adopting GLP1RAs.
A budget impact model that captures the cost of control model was constructed to simulate hypothetical patient on six treatment options: a current mix of 60% liraglutide and 40% dulaglutide, semaglutide, liraglutide, dulaglutide, exenatide, and lixisenatide. We estimated the relative amounts of SAR spend to achieve HbA1c targets (≤6.5% or < 7.0%). For each treatment option, annual treatment cost, proportion of patients achieving HbA1c targets, and cost to treat major adverse cardiovascular events (MACE) were aggregated to estimate the cost of control per patient per year (CCPPPY) over 5-year horizon (2021-2025). Probabilistic sensitivity analysis (PSA) was performed as a confirmatory analysis.
The CCPPPY to achieve HbA1c ≤ 6.5%/<7.0% using current mix, semaglutide, liraglutide, dulaglutide, exenatide, and lixisenatide were SAR 17,097/SAR 14,113, SAR 12,889/SAR 11,123, SAR 15,594/SAR 12,892, SAR 19,184/SAR 15,940, SAR 580,211/SAR 380,936, and SAR 246,570/SAR 143,759, respectively. The relative amounts of SAR spend to achieve HbA1c ≤ 6.5%/<7.0% relative to 1 SAR on semaglutide in case of adopting current mix, liraglutide, dulaglutide, exenatide, and lixisenatide were SAR 1.42/SAR 1.18, SAR 1.30/SAR 1.07, SAR 1.60/SAR 1.33, SAR 48.33/SAR 31.73, and SAR 20.54/SAR 11.97, respectively. These results were confirmed in the PSA.
Semaglutide 1 mg once weekly was the most economically favorable GLP1RA; associated with the least CCPPPY, and amount of SAR spent to achieve HbA1c of ≤6.50%/<7.00% versus all other GLP1RAs.
对沙特阿拉伯（SA）的胰高血糖素样肽-1受体激动剂（GLP1RA）进行成本控制分析，并确定采用GLP1RAs的经济影响。
构建一个捕获成本控制模型的预算影响模型，以模拟假设患者使用六种治疗方案：当前60%利拉鲁肽和40%度拉糖肽的组合、司美格鲁肽、利拉鲁肽、度拉糖肽、艾塞那肽和利司那肽。我们估计了实现糖化血红蛋白（HbA1c）目标（≤6.5%或<7.0%）所需的沙特里亚尔（SAR）支出的相对量。对于每种治疗方案，汇总年度治疗成本、实现HbA1c目标的患者比例以及治疗主要不良心血管事件（MACE）的成本，以估计5年期间（2021 - 2025年）每位患者每年的控制成本（CCPPPY）。进行概率敏感性分析（PSA）作为验证性分析。
使用当前组合、司美格鲁肽、利拉鲁肽、度拉糖肽、艾塞那肽和利司那肽实现HbA1c≤6.5%/<7.0%的CCPPPY分别为17,097沙特里亚尔/14,113沙特里亚尔、12,889沙特里亚尔/11,123沙特里亚尔、15,594沙特里亚尔/12,892沙特里亚尔、19,184沙特里亚尔/15,940沙特里亚尔、580,211沙特里亚尔/380,936沙特里亚尔和246,570沙特里亚尔/143,759沙特里亚尔。在采用当前组合、利拉鲁肽、度拉糖肽、艾塞那肽和利司那肽的情况下，相对于司美格鲁肽1沙特里亚尔实现HbA1c≤6.5%/<7.0%所需的沙特里亚尔支出相对量分别为1.42沙特里亚尔/1.18沙特里亚尔、1.30沙特里亚尔/1.07沙特里亚尔、1.60沙特里亚尔/1.33沙特里亚尔、48.33沙特里亚尔/31.73沙特里亚尔和20.54沙特里亚尔/11.97沙特里亚尔。这些结果在PSA中得到了证实。
每周一次注射1毫克司美格鲁肽是最具经济优势的GLP1RA；与所有其他GLP1RAs相比，其CCPPPY最低，且实现HbA1c≤6.50%/<7.00%所需的沙特里亚尔支出最少。
