ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2025
The Long-Term Cost-Effectiveness of Oral Semaglutide Versus Lower-Cost Liraglutide in the UK.
Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionGlucagon-like peptide-1 (GLP-1) receptor agonists represent efficacious therapies for treating type 2 diabetes. Oral semaglutide is the only orally administered GLP-1 receptor agonist currently available and has been associated with reductions in glycated hemoglobin and body weight versus once-daily injectable liraglutide after 52 weeks in the PIONEER 4 clinical trial. As lower-cost liraglutide formulations have recently been developed, the present analysis evaluated the long-term cost-effectiveness of oral semaglutide 14 mg versus liraglutide 1.8 mg at lower acquisition costs in the UK.
methodsThe published and validated PRIME Type 2 Diabetes Model was used to project clinical and cost outcomes over patient lifetimes. Baseline cohort characteristics, as well as treatment-specific changes in physiological parameters and hypoglycemia rates, were sourced from PIONEER 4. Patients were modeled to receive oral semaglutide or liraglutide until HbA1c exceeded 8.0% (64 mmol/mol), after which treatment was intensified to basal insulin. Annual disutilities associated with treatment administration were applied to capture the differential impact of a once-daily oral versus once-daily injectable medication on quality of life. Costs, expressed in 2022 pounds sterling (GBP), were calculated from a National Health Service (NHS) perspective. The acquisition cost of liraglutide was reduced by up to 50% at increments of 5% across a range of scenarios.
resultsOral semaglutide was associated with improved quality-adjusted life expectancy of 0.18 quality-adjusted life years versus liraglutide 1.8 mg due to a reduced incidence of diabetes-related complications and a reduced treatment-administration burden. Direct, per-person complication costs were estimated to be GBP 187 lower with oral semaglutide. Oral semaglutide remained dominant or cost-effective in the majority of scenarios, even with liraglutide price reductions of 50% applied.
conclusionsOral semaglutide 14 mg was projected to be cost-effective versus lower-cost liraglutide 1.8 mg in the UK.
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