Azuri Joseph, Hammerman Ariel, Aboalhasan Enis, Sluckis Ben, Arbel Ronen
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Maccabi Healthcare Services, Tel Aviv, Israel.
Diabetes Obes Metab. 2023 Apr;25(4):961-964. doi: 10.1111/dom.14940. Epub 2022 Dec 27.
Higher doses of the glucagon-like peptide-1 agonist semaglutide and, more recently, tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 agonist showed a significant reduction in body weight in patients with type 2 diabetes mellitus. However, their comparative value for money for this indication is unclear. Therefore, we aimed to establish which provides better value for money.
We calculated the cost needed to treat to achieve a 1% reduction in body weight using high-dose tirzepatide (15 mg) versus semaglutide (2.4 mg). The body weight reductions were extracted from published results of SURMOUNT-1 and STEP 1 trials, respectively. In addition, we performed a scenario analysis to mitigate the primary differences between the two study populations. Drug costs were based on US GoodRx prices as of October 2022.
Using tirzepatide resulted in a weight loss of 17.8% (95% CI: 16.3%-19.3%) compared with 12.4% (95% CI: 11.5%-13.4%) for semaglutide. The total cost of 72 weeks of tirzepatide was estimated at $17 527 compared with $22 878 for 68 weeks of semaglutide. Accordingly, the cost needed to treat per 1% of body weight reduction with tirzepatide is estimated at $985 (95% CI: $908-$1075) compared with $1845 (95% CI: $1707-$1989) with semaglutide. Scenario analysis confirmed these findings.
Tirzepatide provides better value for money than semaglutide for weight reduction.
更高剂量的胰高血糖素样肽-1激动剂司美格鲁肽，以及最近的替尔泊肽（一种双重葡萄糖依赖性促胰岛素多肽和胰高血糖素样肽-1激动剂）在2型糖尿病患者中显示出显著的体重减轻效果。然而，它们针对这一适应症的性价比尚不清楚。因此，我们旨在确定哪种药物性价比更高。
我们计算了使用高剂量替尔泊肽（15毫克）与司美格鲁肽（2.4毫克）使体重降低1%所需的治疗成本。体重减轻数据分别从SURMOUNT-1和STEP 1试验的已发表结果中提取。此外，我们进行了情景分析以减轻两个研究人群之间的主要差异。药物成本基于截至2022年10月的美国GoodRx价格。
使用替尔泊肽导致体重减轻17.8%（95%置信区间：16.3%-19.3%），而司美格鲁肽为12.4%（95%置信区间：11.5%-13.4%）。72周替尔泊肽的总成本估计为17527美元，而68周司美格鲁肽的总成本为22878美元。因此，使用替尔泊肽每降低1%体重所需的治疗成本估计为985美元（95%置信区间：908美元-1075美元），而司美格鲁肽为1845美元（95%置信区间：1707美元-1989美元）。情景分析证实了这些结果。
在减轻体重方面，替尔泊肽比司美格鲁肽性价比更高。
