IQVIA, London, UK.
IQVIA, Amsterdam, The Netherlands.
Adv Ther. 2023 Mar;40(3):1282-1291. doi: 10.1007/s12325-022-02423-8. Epub 2023 Jan 11.
The objective of the current preliminary study was to present the cost-effectiveness analyses submitted to the National Institute for Health and Care Excellence (NICE) (TA10765) that deemed semaglutide 2.4 mg subcutaneous (s.c.) injection a cost-effective option for weight management in the United Kingdom (UK) alongside diet and exercise (D&E).
The study was conducted from the National Health Service (NHS) and Personal Social Services perspective and based on the NICE reference case. The clinical safety and efficacy of semaglutide 2.4 mg s.c. injection were obtained from the Semaglutide Treatment Effect in People with Obesity (STEP) 1 trial. The previously published and validated Core Obesity Model was used to project lifetime occurrence of obesity complications, their costs and quality of life consequences over 40 years. The base case cohort had a mean starting age of 48 years and BMI of 38.7 kg/m. The confidential NHS price for semaglutide 2.4 mg s.c. injection was provided by Novo Nordisk. The incremental cost-effectiveness ratios (ICERs) were expressed as cost/quality-adjusted life-year (QALY). Uncertainty was assessed through sensitivity analyses, including a scenario analysis using clinical data from the STEP 2 trial and a previously published and validated Core Diabetes Model to investigate a cohort with type 2 diabetes at baseline.
Semaglutide 2.4 mg s.c. injection showed higher total costs and health benefits compared with D&E, with an ICER of £14,827/QALY gained. The probabilistic sensitivity analysis showed that semaglutide 2.4 mg s.c. injection was cost-effective in 90% of cases at a willingness-to-pay threshold of £20,000/QALY. The ICER from the scenario analysis for the diabetic population was £16,613/QALY gained, using the Core Diabetes Model.
Semaglutide 2.4 mg s.c. injection is a cost-effective therapy compared to D&E alone for patients with obesity and weight-related comorbidities in the UK. Sensitivity and scenario analyses confirm the robustness of the analyses.
本初步研究旨在呈现提交给英国国家卫生与保健优化研究所（NICE）（TA10765）的成本效益分析，这些分析认为 2.4 毫克皮下注射司美格鲁肽是英国（UK）在饮食和运动（D&E）基础上进行体重管理的一种具有成本效益的选择。
该研究从国民保健制度（NHS）和个人社会服务的角度出发，并基于 NICE 的参考案例。2.4 毫克司美格鲁肽皮下注射的临床安全性和疗效数据来自于肥胖人群司美格鲁肽治疗效果（STEP）1 试验。先前发表并经过验证的核心肥胖模型被用于预测肥胖相关并发症在 40 年内的终生发生情况、其成本和生活质量后果。基础病例队列的平均起始年龄为 48 岁，BMI 为 38.7kg/m2。诺和诺德公司提供了 2.4 毫克司美格鲁肽皮下注射的保密 NHS 价格。增量成本效益比（ICER）以成本/质量调整生命年（QALY）表示。通过敏感性分析评估不确定性，包括使用 STEP 2 试验的临床数据和先前发表并经过验证的核心糖尿病模型进行的方案分析，以调查基线患有 2 型糖尿病的队列。
与 D&E 相比，2.4 毫克司美格鲁肽皮下注射的总成本和健康效益更高，ICER 为 14827 英镑/QALY。概率敏感性分析显示，在 20000 英镑/QALY 的意愿支付阈值下，2.4 毫克司美格鲁肽皮下注射在 90%的情况下具有成本效益。使用核心糖尿病模型对糖尿病患者进行方案分析的 ICER 为 16613 英镑/QALY。
与单独进行 D&E 相比，2.4 毫克司美格鲁肽皮下注射对英国肥胖和与体重相关合并症患者是一种具有成本效益的治疗选择。敏感性和方案分析证实了分析的稳健性。
