Cost-Effectiveness of Semaglutide vs. Dulaglutide in Diabetes

Introduction to Semaglutide and Dulaglutide

Type 2 diabetes mellitus (T2DM) represents a significant public health challenge globally, and effective management is crucial for reducing complications and improving patient outcomes. Among the various treatment options, glucagon-like peptide-1 (GLP-1) receptor agonists have gained prominence due to their dual action of glycemic control and weight reduction. Two notable medications in this class are semaglutide and dulaglutide.

Semaglutide, a once-weekly injectable GLP-1 receptor agonist, has been associated with significant reductions in HbA1c levels and body weight, leading to improved cardiovascular outcomes (Hu et al., 2025). Dulaglutide, also a GLP-1 receptor agonist, is administered weekly and has shown similar efficacy in glycemic control and weight management. This article aims to evaluate the cost-effectiveness of semaglutide compared to dulaglutide in the management of T2DM, particularly in the context of healthcare systems in China.

Long-Term Cost-Efficiency of Semaglutide in Type 2 Diabetes

A comprehensive cost-effectiveness analysis was conducted using the Institute of Health Economics Diabetes Cohort Model (IHE-DCM) to simulate the long-term health and economic outcomes of semaglutide versus dulaglutide (Hu et al., 2025). The analysis took into account direct medical costs, including antidiabetic treatment and complications, over a 40-year time horizon.

Key Findings:

• Cost Savings: Semaglutide demonstrated a reduction in total direct medical costs. For example, once-weekly semaglutide 0.5 mg resulted in a cost reduction of 5476 Chinese yuan (CNY) compared to dulaglutide 1.5 mg while improving quality-adjusted life years (QALYs) by 0.08.

• QALYs Improvement: Semaglutide 1.0 mg showed an increase of 0.19 QALYs, along with a cost reduction of 6711 CNY compared to dulaglutide, indicating enhanced health outcomes at a lower cost.

• Sensitivity Analysis: The robustness of these results was confirmed through one-way sensitivity analyses and probabilistic sensitivity analyses, indicating that semaglutide remains a cost-effective option for treating T2DM in the Chinese healthcare context.

The findings emphasize the importance of considering both clinical efficacy and economic impact when evaluating diabetes management strategies.

Short-Term Outcomes of Semaglutide Compared to Dulaglutide

In addition to long-term evaluations, a short-term cost-effectiveness analysis focused on the proportion of patients achieving clinical targets was performed. This analysis provided insights into the immediate benefits of treatment with semaglutide versus dulaglutide over a 40-week study period.

Short-Term Analysis Results:

• Success Rates: Semaglutide 0.5 mg exhibited lower treatment costs for achieving glycemic control targets compared to dulaglutide, with costs of control for dulaglutide being 1.2 to 2.1 times higher than those of semaglutide 0.5 mg.

• Clinical Targets: Semaglutide 1.0 mg achieved comparable treatment costs for good glycemic control goals (HbA1c < 7%) while also demonstrating lower treatment costs for weight management targets.

These results underscore the effectiveness of semaglutide in achieving desired clinical outcomes more cost-effectively than dulaglutide in the short term.

Clinical Benefits of Semaglutide on Glycemic Control

The clinical benefits of semaglutide extend beyond cost-effectiveness to encompass significant improvements in glycemic control, weight management, and cardiovascular risk factors.

Clinical Efficacy Data:

• HbA1c Reduction: Clinical trials have indicated that semaglutide leads to greater reductions in HbA1c levels compared to dulaglutide.
• Weight Loss: Patients treated with semaglutide have reported substantial weight loss, a critical factor in the management of T2DM, particularly for overweight patients.
• Cardiovascular Outcomes: Semaglutide has been linked to reduced cardiovascular events, which is particularly significant given the increased cardiovascular risk associated with T2DM.

These clinical benefits contribute to the overall value proposition of semaglutide as a preferred treatment option for T2DM.

Implications for Diabetes Management in China

The findings of this analysis have critical implications for diabetes management in China, where the burden of T2DM is growing rapidly. The cost-effectiveness of semaglutide compared to dulaglutide provides healthcare policymakers with evidence to support the inclusion of semaglutide in national reimbursement drug lists.

Policy Recommendations:

• Healthcare Access: Ensuring access to cost-effective medications like semaglutide can enhance diabetes management and improve patient outcomes across the healthcare system.
• Education and Awareness: Increasing awareness among healthcare providers about the advantages of GLP-1 receptor agonists may promote their usage in clinical practice.
• Long-Term Planning: Policymakers should consider the long-term economic benefits of investing in effective diabetes treatments to mitigate the future healthcare costs associated with diabetes-related complications.

Frequently Asked Questions (FAQs)

What is the main difference between semaglutide and dulaglutide?

Both semaglutide and dulaglutide are GLP-1 receptor agonists used to treat type 2 diabetes. Semaglutide typically offers greater reductions in HbA1c and more significant weight loss compared to dulaglutide.

Why is cost-effectiveness important in diabetes treatment?

Cost-effectiveness analyses help determine the best value for healthcare spending, ensuring that patients receive effective treatments while minimizing financial burdens on healthcare systems.

How do semaglutide and dulaglutide compare in terms of side effects?

Both medications share similar side effects, including gastrointestinal issues. However, individual responses may vary, and it’s essential for patients to discuss their options with healthcare providers.

Is semaglutide covered by insurance in China?

As of the latest updates, semaglutide is included in China’s national reimbursement drug list, making it accessible for patients with type 2 diabetes.

Can lifestyle changes enhance the effectiveness of semaglutide?

Yes, incorporating lifestyle changes such as diet and exercise can further improve glycemic control and weight management in patients taking semaglutide.

References

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