Cost-Effectiveness of Tirzepatide among Adolescents with Recent-Onset Type 2 Diabetes

Introduction and Objective: Youth-onset type 2 diabetes (Y-T2D) is associated with more rapid and higher risk of diabetes-related complications than adult-onset type 2 diabetes. This study aimed to estimate the cost-effectiveness of a newly FDA-approved medication for Y-T2D (tirzepatide) vs standard first-line treatment in Y-T2D. Methods: We developed a microsimulation model to project health and cost outcomes for standard care (metformin 1000 mg BID and lifestyle intervention) and tirzepatide 10 mg weekly over 5 years among a hypothetical cohort of 100,000 adolescents with Y-T2D. Primary outcomes included costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). Secondary outcomes included cumulative incidence of Y-T2D-related complications based on likelihood of a HbA1c ≤ 6.5%. A willingness-to-pay threshold of $100,000 per QALY was used. Results: The model projected tirzepatide to be cost-effective over 5 years with an ICER of $38,765 per QALY gained vs standard care. Cumulative incidence of hypertension, dyslipidemia, kidney disease, nerve disease, and retinopathy was 30%, 26%, 13%, 7% and 32% with standard care and 17%, 11%, 11%, 0%, and 0% with tirzepatide after 5 years. Conclusion: In this study, tirzepatide was cost-effective for adolescents with Y-T2D over 5 years with fewer diabetes-related complications. Comparative effectiveness clinical trials are needed to further evaluate tirzepatide vs current first-line therapy for Y-T2D. Disclosure: F. Lim: None. M.O. Bensignor: Research Support; Current; Dexcom, Inc., Vivus Inc. M. Vajravelu: None. C. Hur: Consultant; Ended; Guardant Health.