Real-world clinical and budget impact of semaglutide in type 2 diabetes mellitus in tertiary hospital in Saudi Arabia.

OBJECTIVE: The aim of this research is to evaluate the clinical and economic benefits of semaglutide in patients with type 2 diabetes mellitus (T2DM) in real-world setting in tertiary hospital in Saudi Arabia. METHODS: In this single-center retrospective chart review study, patients were included if they were adults and diagnosed with T2DM for at least one year between January 2017 and December 2023. Patients were excluded if they had previously received glucagon-like peptide-1 receptor agonist (GLP-1RA). The primary outcomes were HbA1c level and Body Mass Index (BMI). Secondary outcomes were the number of outpatient visits, emergency room visits, hospitalization days and total per patient costs. RESULTS: The study included a total of 186 patients who were initiated on semaglutide. After 12 months on semaglutide, patients' median HbA1c was reduced from 8.9% [8.4 - 9.9] to 7.8% [7.2 - 8.4] (< 0.0001) and BMI from 34.8 kg/m² [31.2 - 38.5] to 32.6 kg/m² [29.5 - 37.1] (< 0.0001). The number of visits decreased from 3.8 ± 1.6 to 2.9 ± 1.5 visits. Hospitalization days reduced from 7.6 ± 7.2 to 4.6 ± 2.3 days. However, the total cost of care increased from SAR 8,660.6 [6,412.6 - 11,352.3] to 10,434.1 [8,738.4 - 12,553.4]. The total mean additional cost per patient per year was SAR 1,964. Subgroup analyses suggest greater efficacy and higher cost in patients with higher baseline HbA1c and BMI levels. CONCLUSION: Semaglutide was associated with significant improvement in glycemic and weight-loss control in adults with T2DM, but this significant change was associated with higher overall cost mainly driven by medication cost.