Anti-Obesity Drugs Tirzepatide and Semaglutide Offer Health Benefits but Cost found prohibitive: New Research Shows

"Lowering the net prices of new anti-obesity medications is crucial for ensuring fair access to these highly effective treatments," Jennifer H. Hwang, Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, and colleagues wrote in JAMA Health Forum.

Obesity poses a significant public health challenge, increasing the risk of diabetes, cardiovascular disease, and other chronic conditions. New treatments like tirzepatide and semaglutide have demonstrated substantial weight loss and improved health outcomes. However, their high costs have raised concerns about affordability, sparking policy debates on their value and insurance coverage.

Against the above background, Dr. Hwang and colleagues aimed to evaluate the cost-effectiveness of four anti-obesity medications combined with lifestyle modification compared to lifestyle modification alone in the U.S.

For this purpose, the researchers conducted a lifetime cost-effectiveness analysis in 2024 using the Diabetes, Obesity, Cardiovascular Disease Microsimulation model for U.S. adults. They analyzed data from the 2017-2020 National Health and Nutrition Examination Survey, including 4,823 individuals representing 126 million eligible adults aged 20 to 79 years who met clinical trial criteria for anti-obesity medications. Individual-level simulations projected long-term cardiometabolic outcomes, quality-adjusted life-years (QALYs), and healthcare costs.

They compared lifestyle modification alone with its combination with naltrexone-bupropion, phentermine-topiramate, semaglutide, or tirzepatide, assessing obesity-related disease reduction, life-years gained, costs, and incremental cost-effectiveness ratios.

The study led to the following findings:

• The study analyzed 126 million eligible U.S. adults with an average age of 48; 51% female, and an initial average BMI of 34.7.
• About 85% had at least one weight-related comorbidity.
• Over a lifetime, tirzepatide could prevent 45,609 obesity cases per 100,000 people, while semaglutide could prevent 32,087 cases.
• Tirzepatide could reduce 20,854 diabetes cases per 100,000 individuals, while semaglutide could reduce 19,211 cases.
• Tirzepatide could lower cardiovascular disease cases by 10,655 per 100,000 individuals, while semaglutide could reduce 8,263 cases.
• Tirzepatide provided the highest quality-adjusted life-year (QALY) gain of 0.35, followed by semaglutide at 0.25.
• The cost-effectiveness ratios were $197,023/QALY for tirzepatide and $467,676/QALY for semaglutide.
• To reach a $100,000/QALY threshold, tirzepatide price would need a 30.5% reduction, and semaglutide price would require an 81.9% cut.
• Naltrexone-bupropion was the most cost-effective, being cost-saving with an 89.1% probability of meeting the $100,000/QALY benchmark.
• Phentermine-topiramate had a 23.5% probability of being cost-effective at $100,000/QALY.
• Tirzepatide and semaglutide had a 0% probability of cost-effectiveness across all examined QALY thresholds ($100,000-$200,000/QALY)

"These findings highlight the importance of continuing efforts to lower the net prices of new anti-obesity medications, ensuring fair and widespread access to these highly effective treatments," the authors concluded.

Reference:

Hwang JH, Laiteerapong N, Huang ES, Kim DD. Lifetime Health Effects and Cost-Effectiveness of Tirzepatide and Semaglutide in US Adults. JAMA Health Forum. 2025;6(3):e245586. doi:10.1001/jamahealthforum.2024.5586