Assessment of Carbon Emission Impact of Semaglutide in Patients With Type 2 Diabetes in the United Kingdom Using an Innovative Modeling Approach.

OBJECTIVES: To evaluate the carbon footprint and clinical outcomes of once-weekly subcutaneous semaglutide in patients with type 2 diabetes mellitus (T2DM) in the United Kingdom. METHODS: Using the IQVIA Core Diabetes Model, environmental and clinical impacts were projected over a lifetime horizon from the National Health Services perspective. Data from the SUSTAIN-2 (patients with T2DM) and SUSTAIN-6 (patients with T2DM and established cardiovascular [CV] risk) trials were used to compare semaglutide with sitagliptin and placebo, respectively. Outcomes included life expectancy measured in life-years (LYs) and quality-adjusted life expectancy measured in quality-adjusted life-years (QALYs) gained, incidence of diabetes-related complications and adverse events, carbon emissions, and incremental carbon footprint effectiveness ratios. RESULTS: In patients with T2DM, semaglutide dominates sitagliptin, with higher discounted LYs (0.096) and QALYs (0.095) gains, a 6.9% reduction in diabetes-related complications and adverse events, and reduced lifetime carbon emissions by 9.3% (13,899 kg carbon dioxide equivalent emissions [COe] versus 15,319 kg COe). Similarly, in patients with T2DM and established CV risk, semaglutide showed higher discounted LYs (0.206) and QALYs (0.164), with reductions in all complications except heart failure-related hospitalizations versus placebo. Lifetime carbon emissions were 5.2% lower with semaglutide (14,546 kg COe versus 15,341 kg COe), again with a dominant carbon footprint effectiveness ratio. The reduction in CO was mainly driven by reduced complications and treatment needs. Sensitivity analyses supported the robustness of the results. CONCLUSION: Semaglutide offers environmental advantages over sitagliptin for patients with T2DM overall and over standard of care for those with established CV risk.