Budget Impact Analysis Shows Zegalogue Could Cut Costs for Severe Hypoglycemia


Treatment with Zegalogue for severe hypoglycemia has the potential to save costs and reduce emergency department visits and hospitalizations.

Severe hypoglycemia treated with Zegalogue (dasiglucagon) as a rescue therapy could result in lower total annual treatment costs when compared with injectable or nasal glucagon, according to a recent budget analysis published in the Journal of Managed Care + Specialty Pharmacy.

Analysts from Boston Healthcare Associates found that potential savings could be $3.3 million per 1 million people per year compared with treatment with injectable glucagon and $7.3 million in savings per 1 million people per year compared with treatment with nasal glucagon.

Additionally, the analysis found that treatment with Zegalogue could reduce the cost of emergency department visits (ED) by $13.5 million and hospitalizations by $18.8 million when compared with no rescue treatment.

When compared with nasal glucagon, Zegalogue could reduce the costs of ED visits by $2.9 and hospitalizations by $4.0 million. When compared with injectable glucagon, Zegalogue could reduce the costs of ED visits by $1.3 million and hospitalizations by $1.9 million.

This budget impact analysis was funded by Zealand Pharma, the manufacturer of Zegalogue. Analysts developed a one-year budget impact model with a hypothetical U.S. commercial health plan of 1 million lives with a target population of individuals with diabetes at risk of severe hypoglycemia events.

“This model demonstrated that dasiglucagon may have a favorable budget impact for U.S. commercial payers because of its high rate of successful administration and subsequent plasma glucose recovery rates, resulting in a lower rate of emergency calls, emergency transports, ED visits, and hospitalizations, leading to overall medical cost savings,” the analysts wrote.

The FDA approved Zegalogue in March 2021 to treat severe hypoglycemia in patients with diabetes aged six and above, and the therapy was launched in the United States in late June 2021. Zegalogue is available as an auto injector and a prefilled syringe.

Severe hypoglycemia is an acute, life-threatening condition resulting from a critical drop in blood glucose levels associated primarily with insulin therapy and is one of the most feared complications of diabetes treatment. Children with diabetes on insulin can be affected, with seven out 100 children up to the age of 18 reporting severe hypoglycemia in the previous six months.

In the second quarter of 2022, Zealand Pharma plans to initiate a clinical study of Zegalogue in children aged 1 to 6 years to explore the safety and effectiveness in this age group.

One limitation, according to the analysts, is that the budget impact model was developed from a commercial payer perspective but used Medicare reimbursement rates, and the analysis conducted from the perspective of the U.S. commercial health plans may not be applicable to other payer types.

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