Cost-utility analysis of glucagon-like peptide-1 receptor agonists for type 2 diabetes mellitus and metabolic dysfunction-associated steatotic liver disease in Thailand

Table 1 Model input parameters

Input parameters	Base-case	SE	Distribution	Source
Efficacy
Relative risk of improvement of at least 1 fibrosis stage without worsening of MASH
Semaglutide	1.334	0.160	Log-normal	[17]
Liraglutide	1.900	0.662	Log-normal	[9]
Transition probability
Fibrosis progression
MASLD F0 → MASLD F1	0.063	0.013	Beta	[20]
MASLD F1 → MASLD F2	0.067	0.013	Beta	[20]
MASLD F2 → MASLD F3	0.056	0.011	Beta	[20]
MASLD F3 → MASLD F4	0.044	0.009	Beta	[20]
MASLD F4 → HCC	0.008	0.002	Beta	[21]
MASLD F4 → DC	0.044	0.009	Beta	[21]
DC → HCC	0.029	0.006	Beta	[21]
DC → LT (Age ≤ 70)	0.003	0.001	Beta	[21]
DC → LT (Age > 70)	0	0	Beta	[21]
HCC → LT (Age ≤ 70)	0.012	0.002	Beta	[21]
HCC → LT (Age > 70)	0	0	Beta	[21]
Fibrosis regression
MASLD F1 → MASLD F0	0.025	0.005	Beta	[20]
MASLD F2 → MASLD F1
Semaglutide	0.060	0.012	Beta
Liraglutide	0.086	0.017	Beta
Usual care	0.045	0.009	Beta	[20]
MASLD F3 → MASLD F2
Semaglutide	0.078	0.016	Beta
Liraglutide	0.111	0.022	Beta
Usual care	0.058	0.012	Beta	[20]
MASLD F4 → MASLD F3
Semaglutide	0.061	0.012	Beta
Liraglutide	0.087	0.017	Beta
Usual care	0.046	0.009	Beta	[20]
Utility
MASLD F0 with T2DM	0.753	0.116	Beta	[22]
MASLD F1 with T2DM	0.753	0.116	Beta	[22]
MASLD F2 with T2DM	0.753	0.116	Beta	[22]
MASLD F3 with T2DM	0.753	0.116	Beta	[22]
MASLD F4/compensated cirrhosis with T2DM	0.748	0.042	Beta	[19]
Decompensated cirrhosis	0.603	0.022	Beta	[25]
HCC	0.310	0.062	Beta	[23,24]
Liver transplant	0.540	0.108	Beta	[23,24]
Post-liver transplant	0.683	0.015	Beta	[25]
Cost
Direct medical cost
Drug cost
Semaglutide			Gamma	[31]
Unit cost (THB/unit)	5585.00	1471.25
Monthly cost (THB/month)	7013.85	NA
Liraglutide			Gamma	[31]
Unit cost (THB/unit)	2337.95	584.49
Monthly cost (THB/month)	7062.00	NA
Direct medical and nonmedical costs (THB/year)
Treatment cost of usual care
MASLD F0 with T2DM	11753.85	4783.27	Gamma	Primary data[35]
MASLD F1 with T2DM	11753.85	4783.27	Gamma	Primary data[35]
MASLD F2 with T2DM	14742.15	6447.42	Gamma	Primary data[35]
MASLD F3 with T2DM	20830.97	7838.66	Gamma	Primary data[35]
MASLD F4/compensated cirrhosis	80469.83	20 117.46	Gamma	[19]
Decompensated cirrhosis	151209.14	37802.29	Gamma	[19]
HCC	184841.21	46210.30	Gamma	[19]
Liver transplant	683568.82	170892.20	Gamma	[19]
Post-liver transplant	110317.81	27579.45	Gamma	[19]

DC: Decompensated cirrhosis; F: Fibrosis stage; HCC: Hepatocellular carcinoma; LT: Liver transplant; MASH: Metabolic dysfunction-associated steatohepatitis; MASLD: Metabolic dysfunction-associated steatotic liver disease; NA: Not applicable; T2DM: Type 2 diabetes mellitus; THB: Thai baht.