Objective  To conduct a rapid health technology assessment (rHTA) of the efficacy, safety, and cost-effectiveness of tirzepatide for the treatment of type 2 diabetes mellitus (T2DM), and to provide evidence for clinical medication.

Methods  PubMed, Web of Science, Embase, Cochrane Library, WanFang Data, CNKI databases, and health technology assessment (HTA) websites were searched to collect systematic reviews/Meta-analysis, pharmacoecomic literature and HTA reports of tirzepatide in the treatment of T2DM from inception to February 28, 2025. Two researchers independently conducted literature screening, data extraction, and quality assessment, and then summarized and analyzed the results.

Results  A total of 13 articles were included, comprising 2 HTA reports, 8 systematic reviews/Meta-analyses, and 3 pharmacoeconomic studies. In terms of efficacy, tirzepatide outperformed placebo or other antidiabetic drugs in reducing glycated hemoglobin (HbA1c), increasing the rate of HbA1c < 7%, lowering blood glucose, and reducing weight. The antihyperglycemic and weight-loss effects of tirzepatide were dose-dependent, and it also had certain advantages in reducing the risk of cardiovascular events and renal composite endpoint events. Regarding safety, the incidence of gastrointestinal adverse events in the tirzepatide group was higher than that in the placebo group and the insulin group, mainly manifested as diarrhea, nausea, and vomiting. However, it did not increase the risk of serious gastrointestinal adverse events, nor did it increase the risk of hypoglycemia and pancreatitis. In terms of cost-effectiveness, tirzepatide had cost-utility and cost-effectiveness advantages compared with semaglutide and other antidiabetic drugs.

Conclusion  Compared with other antidiabetic drugs, tirzepatide has better efficacy, safety, and cost-effectiveness in the treatment of T2DM.

1.Cui Y, Yao J, Qiu X, et al. Comparative efficacy and safety of tirzepatide in Asians and non-Asians with type 2 diabetes mellitus: a systematic review and Meta-analysis[J]. Diabetes Ther, 2024, 15(11): 2443. DOI: 10.1007/s13300-024-01632-4.

2.栗玉杰, 张文静, 杨宏昕, 等. 多格列艾汀治疗2型糖尿病的快速卫生技术评估[J]. 药物流行病学杂志, 2025, 34(4): 448-455. [Li YJ, Zhang WJ, Yang HX, et al. Dorzagliatin in the treatment of type 2 diabetes: a rapid health technology assessment[J]. Chinese Journal of Pharmacoepidemiology, 2025, 34(4): 448-455.] DOI: 10.12173/j.issn.1005-0698.202412057.

3.Institute for Clinical and Economic Review. Tirzepatide for type 2 diabetes [R/OL]. (2023-08-23) [2025-02-26]. https://icer.org/assessment/diabetes-type-2-2022/#timeline.

4.National Institute for Health and Care Excellence. Tirzepatide for treating type 2 diabetes [R/OL]. (2023-10-25) [2025-02-26]. https://www.nice.org.uk/guidance/ta924.

5.Forzano I, Varzideh F, Avvisato R, et al. Tirzepatide: a systematic update[J]. Int J Mol Sci, 2022, 23(23): 14631. DOI: 10.3390/ijms232314631.

6.INAHTA. A checklist for health technology assessment reports [R/OL]. (2007-08) [2024-03-26]. https://www.inahta.org/download/inahta-hta-checklist-english-pdf/?wpdmdl=3884.

7.葛龙, 潘蓓, 潘佳雪, 等. 解读AMSTAR-2基于随机和（或）非随机对照试验系统评价的质量评价工具[J]. 中国药物评价, 2017, 34(5): 334-338. [Ge L, Pan B, Pan JX, et al. An introduction of AMSTAR-2: a quality assessment instrument of systematic reviews including randomized or non-randomized controlled trials or both[J]. Chinese Journal of Drug Evaluation, 2017, 34(5): 334-338.] DOI: 10.3969/j.issn.2095-3593.2017.05.005.

8.Husereau D, Drummond M, Augustovski F, et al. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations[J]. Value Health, 2022, 25(1): 3-9. DOI: 10.1016/j.jval.2021.11.1351.

9.Yao H, Zhang A, Li D, et al. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network Meta-analysis[J]. BMJ, 2024, 384: e076410. DOI: 10.1136/bmj-2023-076410.

10.Nauck MA, D'Alessio DA. Tirzepatide, a dual GIP/GLP-1 receptor co-agonist for the treatment of type 2 diabetes with unmatched effectiveness regrading glycaemic control and body weight reduction[J]. Cardiovasc Diabetol, 2022, 21(1): 169. DOI: 10.1186/s12933-022-01604-7.

11.Frías JP. An update on tirzepatide for the management of type 2 diabetes: a focus on the phase 3 clinical development program[J]. Expert Rev Endocrinol Metab, 2023, 18(2): 111-130. DOI: 10.1080/17446651.2023.2184796.

12.Karagiannis T, Avgerinos I, Liakos A, et al. Management of type 2 diabetes with the dual GIP/GLP-1 receptor agonist tirzepatide: a systematic review and Meta-analysis[J]. Diabetologia, 2022, 65(8): 1251-1261. DOI: 10.1007/s00125-022-05715-4.

13.高宁, 冯冰, 高胜男, 等. 替尔泊肽治疗成人2型糖尿病疗效和安全性的Meta分析[J]. 中国药物经济学, 2024, 19(11): 45-52, 57. [Gao N, Feng B, Gao SN, et al. Efficacy and safety of tirzepatide in the treatment of type 2 diabetes mellitus in adults: a Meta-analysis[J]. China Journal of Pharmaceutical Economics, 2024, 19(11): 45-52, 57.] DOI: 10.12010/j.issn.1673-5846.2024. 11.009.

14.Taktaz F, Scisciola L, Fontanella RA, et al. Evidence that tirzepatide protects against diabetes-related cardiac damages[J]. Cardiovasc Diabetol, 2024, 23(1): 112. DOI: 10.1186/s12933-024-02203-4.

15.Mima A, Gotoda H, Lee R, et al. Effects of incretin-based therapeutic agents including tirzepatide on renal outcomes in patients with type 2 diabetes: a systemic review and Meta-analysis[J]. Metabol Open, 2023, 17: 100236. DOI: 10.1016/j.metop.2023.100236.

16.Zeng Q, Xu J, Mu X, et al. Safety issues of tirzepatide (pancreatitis and gallbladder or biliary disease) in type 2 diabetes and obesity: a systematic review and Meta-analysis[J]. Front Endocrinol (Lausanne), 2023, 14: 1214334. DOI: 10.3389/fendo.2023. 1214334.

17.Hu S, Shi C, Ma Y, et al. Cost-utility analysis and drug pricing for tirzepatide for type 2 diabetes in the Chinese market compared with semaglutide[J]. Diabetes Obes Metab, 2024, 26(8): 3176-3190. DOI: 10.1111/dom.15645.

18.Valentine WJ, Hoog M, Mody R, et al. Long-term cost-effectiveness analysis of tirzepatide versus semaglutide 1.0 mg for the management of type 2 diabetes in the United States[J]. Diabetes Obes Metab, 2023, 25(5): 1292-1300. DOI: 10.1111/dom.14979.

19.Zhang X, McAdam Marx C. Short-term cost-effectiveness analysis of tirzepatide for the treatment of type 2 diabetes in the United States[J]. J Manag Care Spec Pharm, 2023, 29(3): 276-284. DOI: 10.18553/jmcp.2023.29.3.276.

20.Mishra R, Raj R, Elshimy G, et al. Adverse events related to tirzepatide[J]. J Endocr Soc, 2023, 7(4): bvad016. DOI: 10.1210/jendso/bvad016.

21.谢泽宇, 刘一诺, 梁焯茹, 等. 替尔泊肽用于2型糖尿病和长期体重管理的快速卫生技术评估[J]. 中国药房, 2025, 36(9): 1141-1146. [Xie ZY, Liu YN, Liang ZR, et al. Rapid health technology assessment of tirzepatide for type 2 diabetes and long-term weight management[J]. China Pharmacy, 2025, 36(9): 1141-1146.] DOI: 10.6039/j.issn.1001-0408.2025.09.21.