Semaglutide 2.4 mg Could Cut Medical Costs for Some

SAN ANTONIO — Semaglutide 2.4 mg (Wegovy) was associated with a 22% reduction in annual medical costs in people with overweight/obesity and heart failure, new research from Novo Nordisk found.
The significant year-to-year reduction of more than $6500 in total medical costs suggests that the drug “can be an attractive treatment option for this population,” Wojciech Michalak, MSc, Novo Nordisk associate director for data science, said on November 6 at the Obesity Society’s Obesity Week 2024 meeting.
The STEP-HFpEF and STEP-HFpEF-DM trials demonstrated improvements in heart failure symptoms and physical limitations with semaglutide 2.4 mg, in addition to weight loss, whereas the SELECT trial showed significant reductions in major adverse cardiovascular events. But this new study is “to our knowledge, the first study investigating the impact of treatment with semaglutide 2.4 mg on costs in patients with heart failure and overweight or obesity in a real-world setting,” Michalak noted.
Asked to comment, session moderator and obesity researcher Joseph A. Skelton, MD, professor of pediatrics at Wake Forest University School of Medicine, Winston-Salem, North Carolina, told Medscape Medical News, “I think one thing that’s been so remarkable about some of these medications is not just showing weight loss but they’re actually showing some independent cardiovascular effects. And so I think this is another indication they’re looking at not just cardiovascular disease but also patients with heart failure, which is a very expensive condition, and saying, ‘Hey, by doing this, we can actually prevent them from being in the hospital.’ That’s another step.”
However, Skelton cautioned, “this is a study being funded by the company, so you have to take a little bit with a grain of salt and should be verified by someone independently.” 
Medical cost data from a nationally representative claims database were examined for a total of 1267 individuals with overweight or obesity and heart failure who initiated semaglutide 2.4 mg after June 15, 2021, and who had available data for 12 months before and 12 months after the first fill date.
Participants were 60% women, had a mean age of 54.3 years, a mean body mass index of 37.3 kg/m2, and were 49% White. A majority (78%) also had hypertension, 25% had type 2 diabetes, 38% had heart failure with preserved ejection fraction, 67% had dyslipidemia, and 56.5% had obstructive sleep apnea. Most (72%) had commercial health insurance.
Taken together, total medical, inpatient, outpatient, and emergency department costs were $29,561 at baseline vs $23,049 at follow-up, a significant 22% difference of $6512 (P = .001).
Reductions in inpatient, outpatient, and emergency department costs with semaglutide 2.4 mg examined separately were $3368 (26%), $2691 (19%), and $454 (23%), respectively, and were all significant, Michalak said.
Results were similar in a sensitivity analysis of patients without baseline heart failure hospitalizations, producing a total cost saving of $6214 (P = .002).
“The results may not be generalizable to the broader population with heart failure as patients initiating treatment with semaglutide 2.4 mg tend to be younger than those with heart failure in a general population,” he acknowledged.
Michalak is an employee and stockholder of Novo Nordisk. Skelton is the editor-in-chief of the journal Childhood Obesity.
Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape Medical News, with other work appearing in The Washington Post, NPR’s Shots blog, and Diatribe. She is on X: @MiriamETucker.
 
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