Michalak Wojciech, Zhao Zhenxiang, Faurby Mads, Alvarez Sara, Fitch Angela
Novo Nordisk, Inc, Plainsboro, NJ, USA.
knownwell, Boston, MA, USA.
J Med Econ. 2025 Dec;28(1):1075-1085. doi: 10.1080/13696998.2025.2526282. Epub 2025 Jul 12.
BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality. Semaglutide 2.4 mg (Wegovy) has demonstrated improved outcomes in patients with overweight or obesity (ov/ob) and ASCVD, but its impact on medical costs and healthcare resource utilization (HCRU) remains unknown. AIMS: To compare all-cause medical costs and HCRU among patients with ov/ob and ASCVD treated with semaglutide 2.4 mg versus semaglutide-untreated controls. MATERIALS AND METHODS: This observational cohort study utilized Komodo's Healthcare Map and included patients with ov/ob and ≥1 diagnosis of ASCVD during the baseline period with ≥12 months of insurance coverage before and after the index date. Patients in the semaglutide 2.4 mg cohort initiated treatment after 4 June 2021 and stayed adherent. Semaglutide-untreated controls were randomly selected and 1:4 propensity score matched based on baseline demographics, clinical characteristics, medical costs, and HCRU. Medical costs and HCRU were compared using generalized linear models. RESULTS: 770 semaglutide 2.4 mg-treated patients and 3,080 controls were included. In the year following treatment initiation, semaglutide 2.4 mg was associated with 22% lower mean medical costs versus controls (-$4,639 per patient per year [PPPY]; cost ratio = 0.78, 95% confidence interval [CI] 0.67, 0.89). This difference is mainly due to lower inpatient costs with semaglutide 2.4 mg, which were 65% lower than controls (-$3,593; cost ratio = 0.35 [95% CI 0.21, 0.49]), along with a 48% lower inpatient visit rate (0.08 vs. 0.15; rate ratio = 0.52 [95% CI 0.34, 0.70]). LIMITATIONS: Limitations inherent to retrospective claims analyses apply to this study. CONCLUSIONS: This real-world analysis shows significantly lower annual medical costs and HCRU with semaglutide 2.4 mg versus no semaglutide 2.4 mg treatment in patients with ov/ob and ASCVD. Improving outcomes with semaglutide 2.4 mg combined with lower costs and HCRU may help slow the growing burden of ASCVD in this population.
背景：动脉粥样硬化性心血管疾病（ASCVD）是发病和死亡的主要原因。司美格鲁肽2.4毫克（Wegovy）已证明可改善超重或肥胖（ov/ob）且患有ASCVD患者的预后，但其对医疗成本和医疗资源利用（HCRU）的影响尚不清楚。 目的：比较接受2.4毫克司美格鲁肽治疗的ov/ob且患有ASCVD患者与未接受司美格鲁肽治疗的对照者之间的全因医疗成本和HCRU。 材料与方法：这项观察性队列研究使用了科莫多医疗地图，纳入了在基线期患有ov/ob且至少有1次ASCVD诊断、在索引日期前后有至少12个月保险覆盖的患者。司美格鲁肽2.4毫克队列中的患者于2021年6月4日之后开始治疗并持续用药。未接受司美格鲁肽治疗的对照者是随机选择的，并根据基线人口统计学、临床特征、医疗成本和HCRU进行1:4倾向评分匹配。使用广义线性模型比较医疗成本和HCRU。 结果：纳入了770例接受2.4毫克司美格鲁肽治疗的患者和3080例对照者。在开始治疗后的一年中，与对照者相比，2.4毫克司美格鲁肽使平均医疗成本降低了22%（每位患者每年降低4639美元[PPPY]；成本比=0.78，95%置信区间[CI]0.67，0.89）。这种差异主要是由于2.4毫克司美格鲁肽的住院成本较低，比对照者低65%（-3593美元；成本比=0.35[95%CI0.21，0.49]），同时住院就诊率降低了48%（0.08对0.15；率比=0.52[95%CI0.34，0.70]）。 局限性：本研究存在回顾性索赔分析固有的局限性。 结论：这项真实世界分析表明，与未使用2.4毫克司美格鲁肽治疗相比，2.4毫克司美格鲁肽在ov/ob且患有ASCVD的患者中显著降低了年度医疗成本和HCRU。2.4毫克司美格鲁肽改善预后并降低成本和HCRU，可能有助于减缓该人群中ASCVD不断增加的负担。
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