Evaluation of the Clinical Effectiveness and Cost-Effectiveness of Tirzepatide for Type 2 Diabetes in Canada Using Bayesian Transportability Analysis

Tirzepatide was associated with greater weight loss than insulin degludec, and the benefit appeared across all Canadian provinces, territories, ages, and sexes in this transportability analysis. The effect was smaller when trial results were adapted to the Canadian population, and the incremental cost-effectiveness ratio rose from $577.40 to $599.40. The study shows how local evidence can be generated for health decisions.

Journal article — Bayesian transportability analysis and cost-effectiveness modeling. Population: Adults with type 2 diabetes in Canada. Interventions: Tirzepatide.

Both the trial and transported analyses showed a clinical benefit of tirzepatide for weight loss compared with insulin degludec. The benefit was present across all provinces and territories, and across age and sex categories. Trial effects were larger than transported effects. Incremental costs were similar, but the transported analysis gave a higher ICER: $599.40 versus $577.40 for the original trial scenario.

For researchers studying tirzepatide, this paper shows a method for translating trial efficacy into locally relevant estimates for Canadian decision making. It does not establish real-world effectiveness or safety, and it reports only modelled weight loss and short-term cost-effectiveness.

Key findings

• Tirzepatide showed a clinical benefit for weight loss versus insulin degludec in both trial and transported analyses.
• Transported effects were smaller than the original trial effects.
• The ICER for tirzepatide versus insulin degludec was $599.40 under the transported scenario, versus $577.40 under the original trial scenario.
• Weight-loss benefits were seen across all provinces and territories and across age and sex categories.
• Incremental costs were similar between scenarios, but transported incremental benefits were lower.

Limitations

• Transportability analysis adjusts only for measured effect modifiers, so unmeasured differences could bias results.
• The cost-effectiveness model was short-term and does not capture long-term outcomes.
• Survey data were restricted to trial-eligible profiles, which may not represent all Canadians with type 2 diabetes.

The record

• Journal: Value in health regional issues: 101666
• Published: 2026-06-30
• PMID: 42383939 — DOI: 10.1016/j.vhri.2026.101666
• Author countries: Canada, USA

Peptide profiles: Tirzepatide.

All indexed evidence: Tirzepatide trials & papers.

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