ArticlePloS one2026
Cost-effectiveness of semaglutide versus dulaglutide for Type 2 Diabetes in China: A Markov Model analysis.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
objectiveFrom the perspective of China's basic medical insurance, to evaluate the cost-effectiveness of semaglutide versus dulaglutide for type 2 diabetes mellitus (T2DM) in China, informing clinical and health policy decisions.
methodsThis study employed a Markov model to simulate the disease progression of T2DM over a 25-year time horizon. Transition probabilities between health states were sourced from the UK Prospective Diabetes Study Outcomes Model (UKPDS 82) and the SUSTAIN 7 clinical trial, while health utility values were obtained from published literature using the Chinese EQ-5D-5L value set. Long-term cost-effectiveness was projected through cohort simulation, with both one-way sensitivity analysis and probabilistic sensitivity analysis (PSA) conducted to evaluate the robustness of the model.
resultsAfter 25 years of simulation, the total cost for dulaglutide was ¥193,353.07, with 11.628 quality-adjusted life-years (QALYs) gained. The total cost for semaglutide was ¥240,925.08, yielding 11.900 QALYs. Compared with dulaglutide, semaglutide had an incremental cost-effectiveness ratio (ICER) of ¥174,904 per QALY gained, approximately twice China's 2023 per capita GDP (¥89,358). According to the Chinese Guidelines for Pharmacoeconomic Evaluation (2020), this result falls within the economically acceptable range (1 × GDP < ICER ≤ 3 × GDP). One-way sensitivity analysis showed that although health state utility values were the most influential parameter, the model results remained robust. PSA indicated that at a willingness-to-pay (WTP) threshold of 3 times the per capita GDP (¥268,074), semaglutide had an 89.6% probability of being considered economically acceptable.
conclusionFrom the perspective of China's basic medical insurance, semaglutide demonstrates cost-acceptable outcomes compared to dulaglutide in managing type 2 diabetes. This analysis provides crucial evidence for clinical decision-making and health policy formulation.
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