{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T18:09:42Z","timestamp":1781114982802,"version":"3.54.1"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Startup Fund for Scientific Research, Fujian Medical University","award":["2022QH1124"],"award-info":[{"award-number":["2022QH1124"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>From the perspective of China\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After 25 years of simulation, the total cost for dulaglutide was \u00a5193,353.07, with 11.628 quality-adjusted life-years (QALYs) gained. The total cost for semaglutide was \u00a5240,925.08, yielding 11.900 QALYs. Compared with dulaglutide, semaglutide had an incremental cost-effectiveness ratio (ICER) of \u00a5174,904 per QALY gained, approximately twice China\u2019s 2023 per capita GDP (\u00a589,358). According to the Chinese Guidelines for Pharmacoeconomic Evaluation (2020), this result falls within the economically acceptable range (1\u2009\u00d7\u2009GDP\u2009&lt;\u2009ICER\u2009\u2264\u20093\u2009\u00d7\u2009GDP). 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 (\u00a5268,074), semaglutide had an 89.6% probability of being considered economically acceptable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>From the perspective of China\u2019s 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0351059","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T17:39:52Z","timestamp":1781113192000},"page":"e0351059","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness of semaglutide versus dulaglutide for Type 2 Diabetes in China: A Markov Model analysis"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4587-6917","authenticated-orcid":true,"given":"Qiying","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7225-5387","authenticated-orcid":true,"given":"Weicheng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"issue":"5","key":"pone.0351059.ref001","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.2337\/dc19-2519","article-title":"Differential Health Care Use, Diabetes-Related Complications, and Mortality Among Five Unique Classes of Patients With Type 2 Diabetes in Singapore: A Latent Class Analysis of 71,125 Patients","volume":"43","author":"JJB Seng","year":"2020","journal-title":"Diabetes Care"},{"issue":"24","key":"pone.0351059.ref002","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1001\/jama.2021.22208","article-title":"Prevalence and treatment of diabetes in China, 2013-2018","volume":"326","author":"L Wang","year":"2021","journal-title":"JAMA"},{"key":"pone.0351059.ref003","first-page":"100700","article-title":"Projected rapid growth in diabetes disease burden and economic burden in China: a spatio-temporal study from 2020 to 2030","volume":"33","author":"J Liu","year":"2023","journal-title":"Lancet Reg Health West Pac"},{"issue":"11","key":"pone.0351059.ref004","first-page":"836","article-title":"Consensus recommendations on utilizing glucagon-like peptide-1 (GLP-1) receptor agonists in the treatment of type 2 diabetes mellitus","volume":"59","author":"Endocrine Society of the Chinese Medical Association, Diabetes Society of the Chinese Medical Association","year":"2020","journal-title":"Chin J Intern Med"},{"issue":"8","key":"pone.0351059.ref005","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1007\/s00125-020-05151-2","article-title":"Correction to: 2019 update to: Management of hyperglycaemia in type 2 diabetes, 2018. 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