Table 4.

Deterministic sensitivity analyses and scenario analysis results

Label		Low-dose comparison			High-dose comparison
		Semaglutide 0.5 mg vs. dulaglutide 0.75 mg			Semaglutide 1.0 mg vs. dulaglutide 1.5 mg
		Incremental total cost, CAN$	Incremental total QALYs	ICER	Incremental total cost, CAN$	Incremental total QALYs	ICER
Base-case	Assuming 3-year treatment duration, then discontinuation of initial treatments; HbA1c and BMI remain at the level attained	− 403	0.04	Dominant	− 711	0.05	Dominant
Scenario analysis	Assuming HbA1c ‘drifts’ upward at a rate of 0.14% per year, with GLP-1RA treatment discontinued and insulin treatment initiated when patients drift up to the HbA1c threshold of 8%	1977	0.35	5585	1305	0.40	3296
DSA1	Change in HbA1c is the only difference in efficacy between treatments: all other effect parameters are set to zero	− 432	0.02	Dominant	− 427	0.02	Dominant
DSA2	Only statistically significantly different treatment effects from the trials are included in the simulation	− 501	0.03	Dominant	− 386	0.04	Dominant
DSA3	The UKPDS 68 risk equations are used instead of UKPDS 82	− 603	0.04	Dominant	− 733	0.06	Dominant
DSA4	20-year time horizon	− 413	0.03	Dominant	− 666	0.04	Dominant
DSA5	10-year time horizon	− 303	0.02	Dominant	− 415	0.02	Dominant
DSA6	The differences in BMI between treatments are assumed to be maintained throughout the patient’s lifetime	− 533	0.13	Dominant	− 913	0.16	Dominant
DSA7	The upper 95% CI for change in HbA1c is used in the semaglutide arm	− 514	0.04	Dominant	− 830	0.06	Dominant
DSA8	The lower 95% CI for change in HbA1c is used in the semaglutide arm	− 289	0.03	Dominant	− 581	0.05	Dominant
DSA9	The upper 95% CI for change in BMI is used in the semaglutide arm	− 410	0.04	Dominant	− 718	0.07	Dominant
DSA10	The lower 95% CI for change in BMI is used in the semaglutide arm	− 400	0.02	Dominant	− 705	0.05	Dominant
DSA11	Cost of complications assumed to be 10% higher	− 427	0.04	Dominant	− 770	0.05	Dominant
DSA12	Cost of complications assumed to be 10% lower	− 379	0.04	Dominant	− 667	0.05	Dominant
DSA13	Cost of drugs + 10%	− 401	0.04	Dominant	− 710	0.05	Dominant
DSA14	Cost of drugs − 10%	− 405	0.04	Dominant	− 722	0.05	Dominant
DSA15	No explicit insulin-treatment effects assumed; patients’ HbA1c levels remain at 8.0% following upward ‘drift’ to this threshold	1561	0.36	4397	905	0.38	2397

BMI body mass index, CI confidence interval, CAN$ Canadian dollars, DSA deterministic sensitivity analysis, GLP-1RA glucagon-like peptide-1 receptor agonist, HbA_1c glycated hemoglobin, ICER incremental cost-effectiveness ratio, QALY quality-adjusted life-year, UKPDS United Kingdom Prospective Diabetes Study