Once-Weekly Semaglutide Delivers More Diabetes Control per Pound Spent Than Other GLP-1 Drugs in the UK
Despite similar UK drug costs, semaglutide got 21–51% more patients to diabetes treatment goals than exenatide ER, liraglutide, and dulaglutide.
Quick Facts
What This Study Found
Annual per-patient costs were similar across all four GLP-1 receptor agonists in the UK market. However, once-weekly semaglutide consistently outperformed the others in getting patients to treatment goals.
For the composite endpoint of HbA1c below 7.0% without weight gain or low blood sugar episodes, the competing drugs fell short: exenatide ER was 50.0% less effective, liraglutide was 51.3% less effective, and dulaglutide was 21.6% less effective than semaglutide.
Semaglutide also led in single endpoints including HbA1c targets (below 7.0% and below 7.5%) and meaningful weight loss (5% or more body weight reduction).
Key Numbers
Exenatide ER 50.0% less effective; liraglutide 51.3% less effective; dulaglutide 21.6% less effective vs semaglutide at composite endpoint
How They Did This
This was a cost-of-control analysis using clinical data from the SUSTAIN trial program. Researchers compared the proportion of patients reaching various treatment targets across the four drugs and divided annual UK drug costs by efficacy rates to calculate cost per responder.
Why This Research Matters
When multiple drugs in the same class cost about the same, the one that helps the most patients reach their goals offers the best value. This analysis showed semaglutide delivered more clinical benefit per pound spent across every measured outcome.
For healthcare systems making formulary decisions, this type of analysis helps justify choosing one drug over another when prices are similar.
The Bigger Picture
When drugs cost the same, the one that works best for more patients delivers the most value. This analysis provides ammunition for formulary inclusion of semaglutide and for patients and clinicians choosing among GLP-1 options.
What This Study Doesn't Tell Us
This analysis used data from the SUSTAIN clinical trials, which may not perfectly reflect real-world outcomes. Different patient populations, adherence rates, and healthcare settings could change the results.
Prices were based on July 2019 UK wholesale costs, which may have changed since then.
Questions This Raises
- ?Do real-world adherence differences change the cost-effectiveness picture?
- ?How do these compare when weight loss and cardiovascular outcomes are included?
- ?Will semaglutide biosimilars change the competitive landscape?
Trust & Context
- Key Stat:
- 21–51% advantage semaglutide gets significantly more patients to diabetes treatment goals than three competitor GLP-1 drugs at similar UK cost
- Evidence Grade:
- Moderate evidence from cost-of-control analysis based on SUSTAIN clinical trial data. Real-world results may differ.
- Study Age:
- Published in 2020. Drug costs and clinical evidence have evolved since this analysis.
- Original Title:
- A Relative Cost of Control Analysis of Once-Weekly Semaglutide Versus Exenatide Extended-Release, Dulaglutide and Liraglutide in the UK.
- Published In:
- Advances in therapy, 37(3), 1248-1259 (2020)
- Authors:
- Johansen, Pierre(2), Sandberg, Anna, Capehorn, Matthew
- Database ID:
- RPEP-04890
Evidence Hierarchy
Frequently Asked Questions
If GLP-1 drugs cost the same, which should I choose?
This analysis suggests semaglutide gets more patients to their diabetes goals at the same cost. However, individual responses vary, and factors like injection frequency and side effects also matter.
Why compare cost-of-control instead of just drug price?
Two drugs can cost the same per year, but if one gets twice as many patients to target, it is twice as cost-effective. Cost-of-control captures this by dividing cost by efficacy.
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Cite This Study
https://rethinkpeptides.com/research/RPEP-04890APA
Johansen, Pierre; Sandberg, Anna; Capehorn, Matthew. (2020). A Relative Cost of Control Analysis of Once-Weekly Semaglutide Versus Exenatide Extended-Release, Dulaglutide and Liraglutide in the UK.. Advances in therapy, 37(3), 1248-1259. https://doi.org/10.1007/s12325-020-01242-z
MLA
Johansen, Pierre, et al. "A Relative Cost of Control Analysis of Once-Weekly Semaglutide Versus Exenatide Extended-Release, Dulaglutide and Liraglutide in the UK.." Advances in therapy, 2020. https://doi.org/10.1007/s12325-020-01242-z
RethinkPeptides
RethinkPeptides Research Database. "A Relative Cost of Control Analysis of Once-Weekly Semagluti..." RPEP-04890. Retrieved from https://rethinkpeptides.com/research/johansen-2020-a-relative-cost-of
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.