Economic analysis of glucagon like peptide-1 receptor agonists from the Saudi Arabia payer perspective

Nimer S Alkhatib; Abdulaali R Almutairi; Omar S Alkhezi; Osama M Alfayez; Majed S Al Yami; Omar A Almohammed

doi:10.1016/j.jsps.2022.01.018

Economic analysis of glucagon like peptide-1 receptor agonists from the Saudi Arabia payer perspective

Saudi Pharm J. 2022 Apr;30(4):433-439. doi: 10.1016/j.jsps.2022.01.018. Epub 2022 Jan 29.

Authors

Nimer S Alkhatib^{1

2

3

4}, Abdulaali R Almutairi⁵, Omar S Alkhezi⁶, Osama M Alfayez⁷, Majed S Al Yami⁸, Omar A Almohammed⁹

Affiliations

¹ Al-Zaytoonah Health Technology Assessment Center (Z-HTA), College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.
² Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA.
³ College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.
⁴ Midcapital Healthcare, Amman, Jordan.
⁵ Drug Sector, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.
⁶ Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia.
⁷ Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia.
⁸ Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
⁹ Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.

Abstract

Objectives: To perform a cost of control analysis of glucagon like peptide-1 receptor agonists (GLP1RA) in Saudi Arabia (SA) and determine the economic impact of adopting GLP1RAs.

Methods: A budget impact model that captures the cost of control model was constructed to simulate hypothetical patient on six treatment options: a current mix of 60% liraglutide and 40% dulaglutide, semaglutide, liraglutide, dulaglutide, exenatide, and lixisenatide. We estimated the relative amounts of SAR spend to achieve HbA1c targets (≤6.5% or < 7.0%). For each treatment option, annual treatment cost, proportion of patients achieving HbA1c targets, and cost to treat major adverse cardiovascular events (MACE) were aggregated to estimate the cost of control per patient per year (CCPPPY) over 5-year horizon (2021-2025). Probabilistic sensitivity analysis (PSA) was performed as a confirmatory analysis.

Results: The CCPPPY to achieve HbA1c ≤ 6.5%/<7.0% using current mix, semaglutide, liraglutide, dulaglutide, exenatide, and lixisenatide were SAR 17,097/SAR 14,113, SAR 12,889/SAR 11,123, SAR 15,594/SAR 12,892, SAR 19,184/SAR 15,940, SAR 580,211/SAR 380,936, and SAR 246,570/SAR 143,759, respectively. The relative amounts of SAR spend to achieve HbA1c ≤ 6.5%/<7.0% relative to 1 SAR on semaglutide in case of adopting current mix, liraglutide, dulaglutide, exenatide, and lixisenatide were SAR 1.42/SAR 1.18, SAR 1.30/SAR 1.07, SAR 1.60/SAR 1.33, SAR 48.33/SAR 31.73, and SAR 20.54/SAR 11.97, respectively. These results were confirmed in the PSA.

Conclusions: Semaglutide 1 mg once weekly was the most economically favorable GLP1RA; associated with the least CCPPPY, and amount of SAR spent to achieve HbA1c of ≤6.50%/<7.00% versus all other GLP1RAs.

Keywords: Budget impact analysis; Diabetes mellitus; Economic evaluation; GLP1RAs; Saudi Arabia.