Advances in therapyFeb 13, 2020

Comparing the Cost and Benefits of Once-Weekly Semaglutide with Other Weekly and Daily Diabetes Treatments in the UK

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Mar 25, 2026

Abstract

Once-weekly semaglutide 1 mg was superior in achieving treatment goals compared to exenatide ER, dulaglutide, and liraglutide.

Patients treated with once-weekly semaglutide reached HbA1c targets (< 7.0% and < 7.5%) more effectively than those on other GLP-1 RAs.
Weight loss targets (≥ 5% reduction) were achieved more frequently with once-weekly semaglutide compared to its comparators.
In achieving the composite endpoint of HbA1c < 7.0% without weight gain or hypoglycaemia, exenatide ER, dulaglutide, and liraglutide were less efficacious by 50.0%, 21.6%, and 51.3%, respectively.
The cost of control was similar for all GLP-1 RAs, but once-weekly semaglutide showed superior efficacy-to-cost ratios for all endpoints evaluated.

Simplified

INTRODUCTION: Once-weekly semaglutide 1 mg is a novel glucagon-like peptide 1 receptor agonist (GLP-1 RA) that, in the SUSTAIN clinical trials, has demonstrated greater reductions in glycated haemoglobin (HbA1c) and body weight than the other GLP-1 RAs exenatide extended-release (ER) 2 mg, dulaglutide 1.5 mg and liraglutide 1.2 mg. The aim of this analysis was to evaluate the relative cost of control of achieving treatment goals in people with type 2 diabetes (T2D) treated with once-weekly semaglutide versus exenatide ER, dulaglutide and liraglutide from a UK perspective.

METHODS: Proportions of patients reaching HbA1c targets (< 7.0% and < 7.5%), weight loss targets (≥ 5% reduction in body weight) and composite endpoints (HbA1c < 7.0% without weight gain or hypoglycaemia; reduction in HbA1c of ≥ 1% and weight loss of ≥ 5%) were obtained from the SUSTAIN clinical trials. Annual per patient treatment costs were based on wholesale acquisition costs from July 2019 in the UK. Cost of control was calculated by plotting relative treatment costs against relative efficacy.

RESULTS: The annual per patient cost was similar for all GLP-1 RAs. Once-weekly semaglutide was superior to exenatide ER, dulaglutide and liraglutide in bringing patients to HbA1c and weight loss targets, and to composite endpoints. When looking at the composite endpoint of HbA1c < 7.0% without weight gain or hypoglycaemia, exenatide ER, dulaglutide and liraglutide were 50.0%, 21.6% and 51.3% less efficacious in achieving this, respectively, than once-weekly semaglutide. Consequently, the efficacy-to-cost ratios for once-weekly semaglutide were superior to all comparators in bringing patients to all endpoints.

CONCLUSIONS: The present study showed that once-weekly semaglutide offers superior cost of control versus exenatide ER, dulaglutide and liraglutide in terms of achieving clinically relevant, single and composite endpoints. Once-weekly semaglutide 1 mg would therefore represent good value for money in the UK setting.

Key numbers

40.3%

Decrease in Efficacy for HbA1c < 7.0%

Efficacy of exenatide ER 2 mg vs. semaglutide 1 mg

67.3%

Decrease in Efficacy for Weight Loss ≥ 5%

Efficacy of exenatide ER 2 mg vs. semaglutide 1 mg

50.0%

Decrease in Efficacy for Composite Endpoint

Efficacy of exenatide ER 2 mg vs. semaglutide 1 mg for HbA1c < 7.0% without weight gain or hypoglycaemia

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Comparing the Cost and Benefits of Once-Weekly Semaglutide with Other Weekly and Daily Diabetes Treatments in the UK

Abstract

Key numbers

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