Table 5.
Scenario analysis results
| Analysis | Discounted quality-adjusted life expectancy (QALYs) | Discounted direct costs (GBP) | ICER (GBP per QALY gained) | ||||
|---|---|---|---|---|---|---|---|
| Once-weekly semaglutide 1 mg | Empagliflozin 25 mg | Difference | Once-weekly semaglutide 1 mg | Empagliflozin 25 mg | Difference | ||
| Base case | 7.28 | 7.05 | 0.23 | 27,144 | 26,127 | 1017 | 4439 |
| 20-year time horizon | 6.38 | 6.18 | 0.21 | 18,956 | 17,904 | 1052 | 5130 |
| 10-year time horizon | 4.53 | 4.35 | 0.17 | 10,551 | 9311 | 1240 | 7142 |
| 0% discount rates | 10.78 | 10.46 | 0.32 | 49,813 | 48,862 | 951 | 3018 |
| Statistically significant different treatment effects only | 7.28 | 7.05 | 0.23 | 27,174 | 26,127 | 1047 | 4532 |
| Alternative BMI disutility | 6.87 | 6.63 | 0.24 | 27,144 | 26,127 | 1017 | 4298 |
| Alternative hypoglycaemia disutilities | 8.09 | 7.91 | 0.18 | 27,144 | 26,127 | 1017 | 5557 |
| UKPDS 82 risk equations applied | 7.52 | 7.31 | 0.21 | 27,669 | 26,673 | 995 | 4733 |
| Linear annual HbA1c increase while patients receive initial therapies | 7.91 | 7.36 | 0.55 | 27,321 | 25,600 | 1721 | 3149 |
| BMI returned to baseline and then a further increase on intensification | 7.22 | 6.99 | 0.23 | 27,135 | 26,117 | 1017 | 4390 |
| Second intensification to basal-bolus insulin when HbA1c exceeded 7.5% (58 mmol/mol) during basal insulin treatment | 6.05 | 5.73 | 0.32 | 34,419 | 33,977 | 442 | 1378 |
| HbA1c held flat over time, with treatment intensification at 3 years | 7.61 | 7.53 | 0.08 | 23,968 | 22,893 | 1075 | 13,393 |
| Intensification with insulin Semglee | 7.28 | 7.05 | 0.23 | 26,575 | 25,526 | 1049 | 4579 |
| Intensification with insulin Lantus | 7.28 | 7.05 | 0.23 | 27,412 | 26,410 | 1002 | 4373 |
| First-order Monte Carlo simulation | 7.52 | 7.26 | 0.26 | 27,259 | 26,423 | 836 | 3212 |
BMI body mass index, GBP 2019 pounds sterling, HbA1c glycated haemoglobin, ICER incremental cost-effectiveness ratio, QALY quality-adjusted life-year, UKPDS United Kingdom Prospective Diabetes Study