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Objectives Many people with type 2 diabetes experience clinical inertia, remaining in poor glycaemic control on oral glucose-lowering medications rather than intensifying treatment with a glucagon-like peptide-1 receptor agonist, despite an efficacious, orally administered option, oral semaglutide, being available. Interventions Modelled patients received oral semaglutide immediately in the first year of the analysis or after a 2-year delay, after which all physiological parameters were brought to values observed in the immediate therapy arm. During the simulation, patients intensified with the addition of basal insulin and, subsequently, by switching to basal-bolus insulin. Results Immediate oral semaglutide therapy was associated with improvements in life expectancy of 0. Immediate oral semaglutide therapy was therefore associated with an incremental cost-effectiveness ratio of GBP to 10 per QALY gained versus a 2-year delay.

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