AlRuthia Yazed, Hani Aburisheh Khaled, Ata Sondus, Bin Salleeh Raghad, Alqudhibi Shahad B, Alqudhibi Raghad B, Alkraidis Ziad, Humood Alkhalaf Hala, Abdullah Almogirah Abdulrahman, Mujammami Muhammad, Al Khalifah Reem
Department of Clinical Pharmacy, College of Pharmacy, Riyadh, Saudi Arabia.
Pharmacoeconomics Research Unit, Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Saudi Pharm J. 2024 May;32(5):102057. doi: 10.1016/j.jsps.2024.102057. Epub 2024 Mar 29.
Semaglutide, a Glucagon-like Peptide-1 Receptor Agonist (GLP-1 RA), is often prescribed for managing type 2 diabetes, particularly in cases unresponsive to other hypoglycemic agents. Despite its popularity, the real-world efficacy and cost-effectiveness of Semaglutide relative to other treatments remain understudied.
This study aimed to examine the direct medical cost and consequences of adding Semaglutide to the treatment regimen for patients with type 2 diabetes in Saudi Arabia.
We conducted a single-center, retrospective review of Electronic Medical Records (EMRs) for adults with type 2 diabetes. Patients who had been on Semaglutide for at least three months were matched with those receiving alternative hypoglycemic therapies. Exclusions were made for patients with cancer, incomplete EMRs, or lacking prescription data. Investigated outcomes included changes in HbA1C levels and weight, and the direct costs comprised medications, clinic visits, and emergency care. Baseline adjustments were made through inverse probability treatment weighting, and uncertainty was assessed via bootstrapping with 10,000 replications.
Out of 350 patients meeting the criteria, 116 were on Semaglutide. Predominantly females (62%), the cohort had an average age of 60 and a disease duration of 22 years. The difference in HbA1C (%) reductions between Semaglutide and non-Semaglutide users over 3,6, and 12 months were 0.154 (95% CI: -0.452-0.483), -0.031(95% CI: -0.754-0.239), -0.16(95% CI: -1.425-0.840), respectively. Semaglutide users did experience modest weight reductions ranging from 0.42 kg to 1.16 kg. The annual additional direct medical cost for Semaglutide was USD 4,086.82 (95% CI: $3,710.85 - $4,294.99).
Although Semaglutide induced modest weight reductions, it did not offer significant advantages in lowering HbA1C levels compared to other hypoglycemic treatments. These findings suggest the need for further research involving larger and more diverse cohorts to corroborate these findings.
司美格鲁肽是一种胰高血糖素样肽-1受体激动剂（GLP-1 RA），常用于治疗2型糖尿病，尤其是对其他降糖药物无反应的病例。尽管它很受欢迎，但相对于其他治疗方法，司美格鲁肽在现实世界中的疗效和成本效益仍未得到充分研究。
本研究旨在探讨在沙特阿拉伯，将司美格鲁肽添加到2型糖尿病患者治疗方案中的直接医疗成本和后果。
我们对2型糖尿病成人患者的电子病历进行了单中心回顾性研究。将使用司美格鲁肽至少三个月的患者与接受其他降糖治疗的患者进行匹配。排除患有癌症、电子病历不完整或缺乏处方数据的患者。研究结果包括糖化血红蛋白（HbA1C）水平和体重的变化，直接成本包括药物、门诊就诊和急诊护理。通过逆概率治疗加权进行基线调整，并通过10000次重复的自抽样评估不确定性。
在350名符合标准的患者中，116名使用司美格鲁肽。该队列主要为女性（62%），平均年龄60岁，病程22年。司美格鲁肽使用者和非司美格鲁肽使用者在3个月、6个月和12个月时糖化血红蛋白（HbA1C）降低百分比的差异分别为0.154（95%置信区间：-0.452-0.483）、-0.031（95%置信区间：-0.754-0.239）、-0.16（95%置信区间：-1.425-0.840）。司美格鲁肽使用者确实经历了适度的体重减轻，范围从0.42千克到1.16千克。司美格鲁肽每年的额外直接医疗成本为4086.82美元（95%置信区间：3710.85美元-4294.99美元）。
尽管司美格鲁肽能使体重适度减轻，但与其他降糖治疗相比，它在降低糖化血红蛋白水平方面没有显著优势。这些发现表明需要进行进一步的研究，纳入更大和更多样化的队列来证实这些发现。
