Page 113 - GHES-2-4

Global Health Economics and
Sustainability
Cost-effectiveness of oral semaglutide in Greece

in favor of empagliflozin was EUR 122.78 and 606.85, On the contrary, based on PIONEER 4, the cost per
respectively. The cost difference in favor of empagliflozin patient achieving control was lower with oral semaglutide
increased significantly to EUR 1,645.80 and 1,311.67 when 14 mg compared to liraglutide 1.8 mg across all seven
examining the targets of weight loss ≥5% and weight loss treatment targets (Figure 7). Specifically, for the targets of
≥10%, respectively (Table 4). HbA1c ≤6.5% and HbA1c <7%, the cost difference in favor

Based on PIONEER 3, the cost per patient achieving of oral semaglutide 14 mg was EUR 2,022.47 and 872.64,
treatment targets with oral semaglutide 14 mg was higher respectively. The cost difference in favor of oral semaglutide
than that of sitagliptin 100 mg across all assessed outcomes 14 mg remained significantly high at EUR 3,719.66 and
(Figure 6). Specifically, for the targets of HbA1c ≤6.5% 13,807.92 when examining the targets of weight loss ≥5%
and HbA1c <7%, the cost difference in favor of sitagliptin and weight loss ≥10%, respectively (Table 6).
was EUR 1,671.80 and 1,383.46, respectively. The cost 3.4. Sensitivity analysis
difference in favor of sitagliptin remained relatively high
at EUR 1,303.82 and 616.42 when examining the targets The PSA demonstrated that the base case results were
of weight loss ≥5% and weight loss ≥10%, respectively stable when sampling around the mean values of the
(Table 5). efficacy model inputs (Table 7). The PSA results were

Figure 5. Cost per patient achieving treatment targets (PIONEER 2). Figure created using Microsoft Excel

Figure 6. Cost per patient achieving treatment targets (PIONEER 3). Figure created using Microsoft Excel

Table 4. Base case deterministic cost of control comparisons between oral semaglutide and empagliflozin
Treatment targets Oral semaglutide Empagliflozin Difference (oral semaglutide
14 mg (EUR) 25 mg (EUR) – empagliflozin) (EUR)
HbA1c ≤6.5% 2,553.04 2,430.27 122.78
HbA1c ≤7% 1,829.35 1,222.50 606.85
≥1%-point HbA1c reduction 1,912.16 1,237.50 674.66
HbA1c <7% without hypoglycemia and no weight gain 2,171.28 1,353.77 817.51
Weight loss ≥5% 2,994.07 1,348.27 1,645.80
Weight loss ≥10% 8,053.00 6,741.34 1,311.67
≥1%-point HbA1c reduction and weight loss ≥3% 2,833.26 1,997.15 836.11
Abbreviation: HbA1c: Hemoglobin A1C.

Volume 2 Issue 4 (2024) 6 https://doi.org/10.36922/ghes.3032