Dulaglutide (weekly) and liraglutide (daily) equally control blood sugar in women with type 2 diabetes, but dulaglutide costs less and causes fewer injection-related side effects.
Equal efficacy, lower costDulaglutide achieved the same blood sugar, biochemical, and insulin resistance improvements as liraglutide while costing less and causing fewer injection-site complications.
What the researchers found
Both dulaglutide and liraglutide effectively reduced blood glucose, improved biochemical markers, and lowered insulin resistance (HOMA-IR) in women with type 2 diabetes over 24 weeks, with no significant difference in efficacy between the two drugs. However, dulaglutide was more cost-effective — lower overall treatment cost and fewer injection-related side effects — while maintaining equivalent cost-effectiveness ratios.
Why it matters
With GLP-1 drugs being expensive, understanding their comparative cost-effectiveness is crucial for healthcare systems and patients. This study provides real-world evidence that dulaglutide — a weekly injection — offers equivalent blood sugar control to liraglutide (a daily injection) at lower cost and with fewer side effects. The convenience of weekly dosing combined with lower cost and fewer complications makes a strong case for dulaglutide in resource-constrained settings.
The numbers in context
n=96 women · 24-week treatment · 2 groups of 48 · blood glucose reduced in both (p<0.05) · no efficacy difference (p>0.05) · dulaglutide: lower cost (p<0.05) · dulaglutide: fewer side effects (p<0.05) · CER equivalent
How the study worked
Randomized trial of 96 women with type 2 diabetes from June 2019 to December 2021. Patients were equally divided into liraglutide (control) and dulaglutide (observation) groups for 24 weeks. Outcomes included blood glucose levels, biochemical indices, HOMA-IR, cost-effectiveness ratio, and drug safety/side effect incidence.
Who was studied
96 women with type 2 diabetes randomized to dulaglutide or liraglutide for 24 weeks
What this study cannot tell us
The study enrolled only women, so results may not generalize to men. The sample size of 96 is relatively small for a pharmacoeconomic study. Cost data may be specific to the Chinese healthcare system and not applicable globally. The 24-week follow-up may not capture long-term cost-effectiveness differences. Semaglutide (the most commonly prescribed GLP-1 RA) was not included in the comparison.
How to read the evidence
This is a small randomized controlled trial (n=96) with a registered protocol. While the randomized design supports causal conclusions, the small sample size and single-sex population limit generalizability. The pharmacoeconomic analysis adds practical value.
When this study was published
Published in 2023 with data from 2019-2021, this study reflects recent but not the most current GLP-1 drug pricing. Since then, semaglutide has become the dominant GLP-1 RA and pricing dynamics have shifted significantly.
The bigger picture
As healthcare systems worldwide grapple with the cost of GLP-1 drugs, head-to-head pharmacoeconomic comparisons like this are essential. The finding that a weekly injection achieves the same results as a daily one at lower cost and with fewer complications supports the broader trend toward less frequent dosing in peptide therapeutics. This principle now extends to monthly and even longer-acting formulations in development.
Questions still open
- How would semaglutide compare in cost-effectiveness to both dulaglutide and liraglutide in this population?
- Do these cost-effectiveness findings apply to male patients and other healthcare systems outside China?
- Would even longer-acting GLP-1 formulations (monthly depot) offer further cost advantages?
Common questions
Why is dulaglutide cheaper if both drugs work equally well?
Why was this study done only in women?
Read the original research
Pharmacoeconomic analysis (CER) of Dulaglutide and Liraglutide in the treatment of patients with type 2 diabetes.
Frontiers in endocrinology, 14, 1054946
Citation
Su, Yu; Zhang, Shuo; Wu, Zezhen; Liu, Weiting; Chen, Jingxian; Deng, Feiying; Chen, Fengwu; Zhu, Dan; Hou, Kaijian. (2023). Pharmacoeconomic analysis (CER) of Dulaglutide and Liraglutide in the treatment of patients with type 2 diabetes.. Frontiers in endocrinology, 14, 1054946. https://doi.org/10.3389/fendo.2023.1054946