Hormonal
Semaglutide 2.4 mg weekly reduces all-cause mortality and major adverse cardiovascular events in overweight/obese patients with preexisting cardiovascular disease but no diabetes, yet remains cost-ineffective at current pricing relative to standard care.
For a patient with heart disease and obesity but no diabetes: Semaglutide 2.4mg weekly significantly lowers your risk of heart attack, stroke, and death compared to standard care. However, because the drug is expensive, public health systems may not cover it unless the price drops. You should discuss the clinical benefits with your doctor, but be aware that insurance coverage might be denied or require prior authorization due to cost-effectiveness thresholds.
Base case analysis showed that the incremental cost-effectiveness ratio for semaglutide compared with standard care was $72,962 per QALY gained with a 14% likelihood of cost-effectiveness adopting a $50,000 per QALY gained willingness to pay threshold... When the price of semaglutide was reduced by 50%, it was economically attractive at $37,190 per QALY gained with an 80% likelihood of cost-effectiveness at a $50,000 per QALY threshold.
Why this rating
Based on a decision-analytic Markov model using data from the high-quality SELECT randomized trial.
Source
Cost-Effectiveness of Semaglutide in Patients With Obesity and Cardiovascular Disease
Elissa Rennert‐May et al. · Canadian Journal of Cardiology · 2025
DOI 10.1016/j.cjca.2024.09.025
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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