Lifetime Health Effects and Cost-Effectiveness of Tirzepatide and Semaglutide in US Adults

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JH Hwang et al. JAMA Health Forum. 2025;6(3):e245586. Open Access! Lifetime Health Effects and Cost-Effectiveness of Tirzepatide and Semaglutide in US Adults

Methods: The authors modeled the effects of four medications,  tirzepatide and semaglutide compared to phentermine-topiramate and naltrexone-bupropion. The study used data from the 2017-2020 National Health and Nutrition Examination Survey. This included 4823 individuals (representing 126 million eligible US adults) aged 20 to 79 years who would meet the following clinical trial inclusion criteria for these drugs: (1) had a body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 30 or greater or (2) had a BMI between 27 and 29.9 and at least 1 weight-related comorbidity (ie, diabetes, hypertension, dyslipidemia, or cardiovascular disease).

Key results:

  • Based on this model, in US adults, over a lifetime, tirzepatide would avert 45,609 obesity cases per 100,000 individuals and and semaglutide would avert 32,087 cases per 100,000 individuals.
  • Tirzepatide and Semaglutide would avert cases of diabetes by 20,854 per 100,000 individuals and 19,211 cases per 100,000 individuals respectively.
  • Tirzepatide and Semaglutide would avert cardiovascular disease cases by 10,655 per 100,000 individuals and 8,263 cases per 100,000 individuals respectively.
  • Despite the largest incremental QALY gains of 0.35 for tirzepatide and 0.25 for semaglutide among all antiobesity medications, the incremental cost-effectiveness ratios were $197,023/QALY and 467,676/QALY, respectively.
  • To reach the $100,000/QALY threshold, their prices would require additional discounts by 30.5% for tirzepatide and 81.9% for semaglutide from their current net prices.

In short, the authors indicate that based on a typical QALY threshold for cost-effectiveness, tirzepatide would need to be priced at $4,334 per year, from the current average of $6,236 per year; semaglutide would need to be $1,522 per year, from an average of about $8,412 per year today.

My take: The costs of these drugs in non-US markets would meet the QALY threshold for cost-effectiveness. However, until the patent on these drugs expires, US consumers are likely to be spending a great deal more. The U.S. patent on semaglutide will expire in 2032, and the U.S. patent on tirzepatide will expire in 2036.

CNN 9/24/24 ‘Greed, greed, greed’: Sanders demands Ozempic maker lower prices: “He {Bernie Sanders] noted that the list price for a four-week supply of Ozempic is $969 in America, but the drug can be purchased for $155 in Canada, $122 in Denmark and $59 in Germany. Similarly, Wegovy’s list price is $1,349 in the US, but it costs $186 in Denmark, $140 in Germany and $92 in the United Kingdom.”

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