Supplementary materials: The cost–effectiveness of oral semaglutide versus empagliflozin in Type 2 diabetes in Denmark

<b>These are peer-reviewed supplementary material for the article ‘</b><b>The cost–effectiveness of oral semaglutide versus empagliflozin in Type 2 diabetes in Denmark’ </b><b>published in the </b><b><i>Journal of Comparative Effectiveness Research</i></b><b>.</b><b>Table S1</b>: Baseline Characteristics.<b>Table S2</b>: Treatment Effects – First Line.<b>Table S3</b>: Adverse Events.<b>Table S4</b>: Treatment effects for second/third line treatments (treatment policy estimand).<b>Table S5</b>: Proportion of patients on preventive medication.<b>Table S6</b>: Screening and patient management proportions.<b>Table S7</b>: Sensitivity and specificity of tests.<b>Table S8</b>: Annual treatment costs applied (DKK, AIP 2020, [20]).<b>Table S9</b>: Cost Inputs for the CDM (Costs inflated to 2020 values, DKK).<b>Table S10</b>: Utilities used in CDM.<b>Table S11</b>: Scenario analysis results.<b>Table S12</b>: Breakdown of costs (DKK, per average patient).<b>Summary: </b><b>Aim:</b> To evaluate the cost–effectiveness of oral semaglutide+metformin versus empagliflozin+metformin in people with Type 2 diabetes uncontrolled on msetformin alone. <b>Materials and methods:</b> The IQVIA Core Diabetes Model was populated with efficacy data from a head-to-head study between oral semaglutide+metformin and empagliflozin+metformin. Danish costs and quality-of-life data were sourced from literature. Price per day was Danish Krone (DKK) 25.53 for oral semaglutide and DKK11.40 for empagliflozin. Discounting was fixed at 4%. Scenario and sensitivity analyses were performed. <b>Results:</b> Over a lifetime, Core Diabetes Model projected 8.78 and 8.75 quality-adjusted life-years and a total cost of DKK 447,633 and DKK 387,786, thereby generating an incremental cost–effectiveness ratio of DKK 1,930,548 for oral semaglutide+metformin versus empagliflozin+metformin. Scenario and sensitivity analyses showed the robustness of the outcomes. Duration of treatment with oral semaglutide is the key driver of the analyses. <b>Conclusion:</b> Oral semaglutide+metformin seems not cost effective versus empagliflozin+metformin in patients uncontrolled on metformin in Denmark.

本内容为发表于《Journal of Comparative Effectiveness Research》（《比较效果研究杂志》）的论文《丹麦2型糖尿病患者口服司美格鲁肽对比恩格列净的成本-效果分析》的同行评议补充材料。
表S1：基线特征
表S2：治疗效果——一线治疗方案
表S3：不良事件
表S4：二线/三线治疗方案的治疗效果（治疗策略估计量）
表S5：预防性用药患者占比
表S6：筛查与患者管理占比
表S7：检测的灵敏度与特异度
表S8：适用年度治疗成本（丹麦克朗（Danish Krone, DKK），AIP 2020，参考文献[20]）
表S9：临床决策模型（Clinical Decision Model, CDM）的成本输入项（成本已折算至2020年价值，单位：丹麦克朗）
表S10：临床决策模型中使用的效用值
表S11：情景分析结果
表S12：成本构成（丹麦克朗，每例平均患者）
研究概要：
研究目标：评估单用二甲双胍血糖控制不佳的2型糖尿病患者中，口服司美格鲁肽联合二甲双胍对比恩格列净联合二甲双胍的成本-效果性。
研究方法：本研究采用IQVIA核心糖尿病模型（IQVIA Core Diabetes Model），纳入口服司美格鲁肽+二甲双胍与恩格列净+二甲双胍头对头临床试验的疗效数据；丹麦地区的治疗成本与生命质量数据来源于已发表文献。口服司美格鲁肽的单日治疗价格为25.53丹麦克朗，恩格列净为11.40丹麦克朗。贴现率固定为4%，并开展了情景分析与敏感性分析。
研究结果：经核心糖尿病模型终生模拟，口服司美格鲁肽+二甲双胍组与恩格列净+二甲双胍组的质量调整生命年分别为8.78和8.75年，总治疗成本分别为447633丹麦克朗与387786丹麦克朗，由此计算得到口服司美格鲁肽+二甲双胍对比恩格列净+二甲双胍的增量成本-效果比为1930548丹麦克朗。情景分析与敏感性分析证实了研究结果的稳健性，口服司美格鲁肽的治疗时长是本研究分析的关键影响因素。
研究结论：在丹麦单用二甲双胍血糖控制不佳的2型糖尿病患者中，口服司美格鲁肽联合二甲双胍相较于恩格列净联合二甲双胍不具备成本-效果优势。