Trabalhos Aprovados

Incorporating Cardio-protective Effects of Once-weekly Semaglutide in Estimates of Health Benefits for Patients with Type 2 Diabetes



Autor(es): Cavalari, EMR; Evans, M; Johansen, P; Vrazic, H;
Apresentador(a): Emanuela Cavalari

BACKGROUND:As the prevalence of type 2 diabetes (T2D) increases globally, the condition and its associated complications are generating a considerable economic burden within health care systems. AIM: With the use of economic modeling techniques, we sought to calibrate existing risk equations to account for the stroke (fatal and non-fatal) benefit observed with once-weekly semaglutide in SUSTAIN 6. As a secondary objective, the impact of incorporating the stroke benefit on estimated long-term health benefits was assessed. METHODS:The IQVIA Core Diabetes Model (CDM) 9.0, a validated and extensively used microsimulation economic model, was used for these analyses. At simulation start, patients were assigned treatment with either once-weekly semaglutide+ standard of care(SoC) or placebo+SoC. Baseline patient characteristics as well as risk factor progression were extracted from the SUSTAIN 6 trial. The CDM was calibrated to incorporate the stroke benefit of once-weekly semaglutide. A 50-year time horizon was used for the long-term projections. Utilities associated with diabetes-related complications were sourced from a previously published literature review from Evans et al. RESULTS:The UKPDS 68 and 82 equations were able to predict 64% and 50%, respectively, of the observed 2-year stroke risk reduction, suggesting a drug-mechanistic effect other than that observed through changes in the risk factors. The simulated cumulative incidence ratios were 0.78 and 0.83 for UKPDS 68 and 82 equations, respectively. Calibration results indicated that a stroke RR of 0.83 (17% reduction) for UKPDS 68 and 0.75 (25% reduction) for UKPDS 82 applied to once-weekly semaglutide+SoC was required to preserve the trial-observed cumulative incidence ratio between treatment arms. Including the stroke benefit for once-weekly semaglutide and extrapolating over a 50-year time horizon showed that quality-adjusted life years and life years were increased by 0.18 and 0.29, respectively, for once-weekly semaglutide relative to placebo+SoC using UKPDS 68 equations. Similar results were obtained using UKPDS 82 equations. CONCLUSION: Our findings suggest a drug-mechanistic effect of once-weekly semaglutide over and above what is predicted by traditional risk equations through observed changes in risk factors. Results of this analysis may have implications on future approaches to assess the long-term economic impact of new therapies in T2D in this era of multiple cardiovascular outcomes trials.

Palavras-chave: Type 2 Diabetes; Semaglutide; economic impact

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