Cost-effectiveness analysis of once-daily oral semaglutide versus placebo and subcutaneous glucagon-like peptide-1 receptor agonists added to insulin in patients with type 2 diabetes in China.

Feng Z, Tong WK, Zhang X, Tang Z

Frontiers in pharmacology9 Aug 2023Cited by 9 (Europe PMC)

PMID37621313PMCIDPMC10445164DOI10.3389/fphar.2023.1226778PepBankPUB-37621313

Summary

Introduction: Oral semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) that improves glycated hemoglobin levels and body weight in patients with type 2 diabetes (T2DM). We aim to evaluate the cost-effectiveness of once-daily oral semaglutide in comparison to placebo and injectable GLP-1 RAs in Chinese patients with T2DM inadequately controlled on basal insulin. Methods: The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER). Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial. Utility and safety inputs were derived from a network meta-analysis of 12 trials. Direct medical costs were retrieved from published literature and discounted at an annual rate of 5%. We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained. Scenario analysis, and one-way and probabilistic sensitivity analysis were performed. Results: The effectiveness of oral semaglutide was 10.39 QALYs with a total cost of $30,223.10, while placebo provided 10.13 QALYs at a lower total cost of $20,039.19. Oral semaglutide was not cost-effective at an ICER of $39,853.22 and $88,776.61 per QALY compared to placebo and exenatide at the WTP. However, at an annual price of $1,871.9, it was cost-effective compared with dulaglutide, liraglutide, and lixisenatide. The model was most sensitive to the discount rate and annual cost of oral semaglutide. The price of oral semaglutide needed to be reduced to $1,711.03 per year to be cost-effective compared to placebo and other injectable GLP-1 RAs except for exenatide and semaglutide injection. Conclusion: We found that once-daily oral semaglutide, at a comparable price of semaglutide injection, proves to be a cost-effective add-on therapy to insulin for Chinese patients with T2DM, especially when compared to subcutaneous GLP-1 RAs other than injectable semaglutide and exenatide. However, to achieve cost-effectiveness in comparison to placebo, further cost reduction of oral semaglutide is necessary. The estimated annual cost of $1,711.03 for oral semaglutide demonstrates a more cost-effective option than placebo, highlighting its potential value in the management of T2DM.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study11

No result from this study comes from a test of the peptide.

Studies that did not test the peptide alone11

In this study, the peptide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking the peptide.

01Computer modelNot a test of Semaglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide yielded 10.39 QALYs versus 10.13 with placebo.
In plain wordsIn computer modelling, oral semaglutide produced more quality-adjusted life years than placebo.
Peptide
Semaglutide
Outcome
IncreaseQuality-adjusted life years
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Placebo
Outcome group
Cost-effectiveness · Pharmacology
Measurements
Effectiveness
10.39 QALYs
oral semaglutide
Effectiveness
10.13 QALYs
placebo
Source sentences
Summary
The effectiveness of oral semaglutide was 10.39 QALYs with a total cost of $30,223.10, while placebo provided 10.13 QALYs at a lower total cost of $20,039.19.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-3762131301
02Computer modelNot a test of Semaglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide cost $30,223.10 versus $20,039.19 for placebo.
In plain wordsIn computer modelling, oral semaglutide cost more than placebo.
Peptide
Semaglutide
Outcome
IncreaseTotal medical cost
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Placebo
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
The effectiveness of oral semaglutide was 10.39 QALYs with a total cost of $30,223.10, while placebo provided 10.13 QALYs at a lower total cost of $20,039.19.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-3762131302
03Computer modelNot a test of Semaglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide was not cost-effective versus placebo at an ICER of $39,853.22 per QALY.
In plain wordsIn computer modelling, oral semaglutide was not cost-effective compared with placebo at the selected willingness-to-pay threshold.
Peptide
Semaglutide
Outcome
Not applicableCost-effectiveness versus placebo
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Placebo
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
Oral semaglutide was not cost-effective at an ICER of $39,853.22 and $88,776.61 per QALY compared to placebo and exenatide at the WTP.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-3762131303
04Computer modelNot a test of Semaglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide was not cost-effective versus exenatide at an ICER of $88,776.61 per QALY.
In plain wordsIn computer modelling, oral semaglutide was not cost-effective compared with exenatide at the selected willingness-to-pay threshold.
Peptide
Semaglutide
Outcome
Not applicableCost-effectiveness versus exenatide
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Exenatide
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
Oral semaglutide was not cost-effective at an ICER of $39,853.22 and $88,776.61 per QALY compared to placebo and exenatide at the WTP.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-3762131304
05Computer modelNot a test of Semaglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide at $1,871.9 annually was cost-effective compared with dulaglutide.
In plain wordsIn computer modelling, oral semaglutide was cost-effective compared with dulaglutide at the stated annual price.
Peptide
Semaglutide
Outcome
Not applicableCost-effectiveness versus dulaglutide
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Dulaglutide
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
However, at an annual price of $1,871.9, it was cost-effective compared with dulaglutide, liraglutide, and lixisenatide.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-3762131305
06Computer modelNot a test of Dulaglutide (Trulicity) aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide at $1,871.9 annually was cost-effective relative to dulaglutide.
In plain wordsIn computer modelling, oral semaglutide was cost-effective relative to dulaglutide at the stated annual price.
Peptide
Dulaglutide (Trulicity)
Outcome
Not applicableCost-effectiveness relative to oral semaglutide
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Oral semaglutide
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
However, at an annual price of $1,871.9, it was cost-effective compared with dulaglutide, liraglutide, and lixisenatide.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Dulaglutide (Trulicity) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Dulaglutide (Trulicity).
Show in the study text Report a problemFND-3762131306
07Computer modelNot a test of Semaglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide at $1,871.9 annually was cost-effective compared with liraglutide.
In plain wordsIn computer modelling, oral semaglutide was cost-effective compared with liraglutide at the stated annual price.
Peptide
Semaglutide
Outcome
Not applicableCost-effectiveness versus liraglutide
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Liraglutide
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
However, at an annual price of $1,871.9, it was cost-effective compared with dulaglutide, liraglutide, and lixisenatide.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-3762131307
08Computer modelNot a test of Liraglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide at $1,871.9 annually was cost-effective relative to liraglutide.
In plain wordsIn computer modelling, oral semaglutide was cost-effective relative to liraglutide at the stated annual price.
Peptide
Liraglutide
Outcome
Not applicableCost-effectiveness relative to oral semaglutide
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Oral semaglutide
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
However, at an annual price of $1,871.9, it was cost-effective compared with dulaglutide, liraglutide, and lixisenatide.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-3762131308
09Computer modelNot a test of Semaglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide at $1,871.9 annually was cost-effective compared with lixisenatide.
In plain wordsIn computer modelling, oral semaglutide was cost-effective compared with lixisenatide at the stated annual price.
Peptide
Semaglutide
Outcome
Not applicableCost-effectiveness versus lixisenatide
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Lixisenatide
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
However, at an annual price of $1,871.9, it was cost-effective compared with dulaglutide, liraglutide, and lixisenatide.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-3762131309
10Computer modelNot a test of Semaglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide results were most sensitive to discount rate and its annual cost.
In plain wordsIn computer modelling, discount rate and oral semaglutide annual price most strongly influenced the results.
Peptide
Semaglutide
Outcome
Not applicableModel sensitivity
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
The model was most sensitive to the discount rate and annual cost of oral semaglutide.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-3762131310
11Computer modelNot a test of Semaglutide aloneIn silicoOther
In the Chinese T2DM simulation, oral semaglutide required an annual price of $1,711.03 for cost-effectiveness against the specified comparator pool.
In plain wordsIn computer modelling, oral semaglutide required a lower annual price for cost-effectiveness against placebo and most injectable comparators.
Peptide
Semaglutide
Outcome
Not applicableAnnual price threshold
Study
n: not reported in source
UKPDS OM2.1 simulation of Chinese T2DM patients on basal insulin
Comparator
Placebo and injectable GLP-1 receptor agonists except exenatide and injectable semaglutide
Outcome group
Cost-effectiveness · Pharmacology
Source sentences
Summary
The price of oral semaglutide needed to be reduced to $1,711.03 per year to be cost-effective compared to placebo and other injectable GLP-1 RAs except for exenatide and semaglutide injection.
3 context sentences(design, population, supporting numbers)
Summary · context
The United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS OM2.1) was used to estimate the cost-effectiveness by calculating the incremental cost-effectiveness ratio (ICER).
Summary · context
Baseline characteristics of the simulation cohort were obtained from the PIONEER 8 trial.
Summary · context
We used a willingness-to-pay (WTP) threshold of $36,528.3 per quality-adjusted life-year (QALY) gained.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-3762131311

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 5Current
27 Oct 2026, 16:36 UTC
Study data updated · source update from Europe PMC
Version 4
22 Oct 2026, 02:25 UTC
Study results updated
Versions 2 to 3
21 Oct 2026, 18:59 UTC
The same notice was added 2 times, first on 9 Oct 2026, 03:06 UTC. The status did not change between them.
Study data updated · source update from Europe PMC
Version 1
9 Oct 2026, 03:05 UTC
First added · source update from Europe PMC

Cost-effectiveness analysis of once-daily oral semaglutide versus placebo and subcutaneous glucagon-like peptide-1 receptor agonists added to insulin in patients with type 2 diabetes in China.

Summary

Results from this study11

Studies that did not test the peptide alone11

Version history

Subjects

Publication types

Keywords