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. 2019 Mar 29;3(4):537–550. doi: 10.1007/s41669-019-0131-6

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, HbA1c glycated hemoglobin, ICER incremental cost-effectiveness ratio, QALY quality-adjusted life-year, UKPDS United Kingdom Prospective Diabetes Study