Evidence mapPaperPMID 39708085Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2025

The Long-Term Cost-Effectiveness of Tirzepatide 5 mg versus Dulaglutide 0.75 mg for the Treatment of People with Type 2 Diabetes in Japan.

Toshihiko Aranishi, Ataru Igarashi, Kazuo Hara, Beatrice Osumili, Zhihong Cai, Aska Mizogaki, Manaka Sato, Masakazu Takeuchi, Alice Minghetti, Barnaby Hunt and 1 more

Erratum issuedAbstract read
In one paragraph

Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Toshihiko AranishiEli Lilly Japan K.K., 5-1-28 Isogami-dori, Chuo-Ku, Kobe, Japan.ORCID http://orcid.org/0000-0001-8862-9468
Ataru IgarashiDepartment of Health Policy and Public Health, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 13-0033, Japan.ORCID http://orcid.org/0000-0001-6307-6916
Kazuo HaraDivision of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
Beatrice OsumiliEli Lilly and Company Limited, 8 Arlington Square West, Downshire Way, Bracknell, RG12, 1PU, UK.ORCID http://orcid.org/0000-0002-5862-9325
Zhihong CaiEli Lilly Japan K.K., 5-1-28 Isogami-dori, Chuo-Ku, Kobe, Japan.ORCID http://orcid.org/0000-0002-3431-197X
Aska MizogakiEli Lilly Japan K.K., 5-1-28 Isogami-dori, Chuo-Ku, Kobe, Japan.
Manaka SatoEli Lilly Japan K.K., 5-1-28 Isogami-dori, Chuo-Ku, Kobe, Japan.ORCID http://orcid.org/0000-0001-7000-4769
Masakazu TakeuchiEli Lilly Japan K.K., 5-1-28 Isogami-dori, Chuo-Ku, Kobe, Japan.ORCID http://orcid.org/0000-0003-3176-3118
Alice MinghettiOssian Health Economics and Communications GmbH, Bäumleingasse 20, 4051, Basel, Switzerland.ORCID http://orcid.org/0000-0001-7913-5861
Barnaby HuntOssian Health Economics and Communications GmbH, Bäumleingasse 20, 4051, Basel, Switzerland. hunt@ossianconsulting.com.ORCID http://orcid.org/0000-0001-5420-279X
Takashi KadowakiToranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis analysis aimed to evaluate the long-term cost-effectiveness of tirzepatide 5 mg versus dulaglutide 0.75 mg (both administered once weekly) in people not achieving glycemic control on metformin, based on the results of the head-to-head SURPASS J-mono trial from a Japanese healthcare payer perspective.

methodsA cost-utility analysis was performed over a 50-year time horizon using an implementation of the UKPDS Outcomes Model 2 developed in Microsoft Excel. Baseline cohort characteristics, treatment effects and adverse event rates were sourced from the SURPASS J-mono trial. Simulated patients were assumed to receive either tirzepatide 5 mg or dulaglutide 0.75 mg until HbA1c exceeded 8.0%, at which point treatment was discontinued and basal insulin was initiated. Direct costs were derived from the Japan Medical Data Center claims database. Future costs and clinical benefits were discounted at 2% annually.

resultsIn this cost-utility modeling analysis, tirzepatide 5 mg was associated with lower diabetes-related complication rates, improved life expectancy, improved quality-adjusted life expectancy and higher direct costs versus dulaglutide 0.75 mg. This resulted in an incremental cost-effectiveness ratio (ICER) of JPY (Japanese yen) 1,302,240 per quality-adjusted life year (QALY) gained for tirzepatide 5 mg versus dulaglutide 0.75 mg (JPY 140 = USD 1). Tirzepatide remained cost-effective versus dulaglutide over a range of sensitivity analyses.

conclusionsIn this analysis, tirzepatide 5 mg was associated with an ICER below the commonly quoted willingness-to-pay threshold of JPY 5,000,000 per QALY gained, suggesting that tirzepatide is a cost-effective treatment option for adult patients with type 2 diabetes mellitus, compared with dulaglutide 0.75 mg.

Indexed as

Cost-effectivenessJapanModelingTirzepatideType 2 diabetes mellitus

Identifiers

PMID39708085
PMCPMC11868005

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.