{"id":"doi:10.1002/oby.70311","kind":"article","title":"The Conventional Cost-Effectiveness and Distributional Cost-Effectiveness of Semaglutide for Obesity Treatment","authors":["Kulkarni NS","Hutton D","Rhyan C","McCullough JS","Greenlee M","Pandya A"],"author_count":6,"year":2026,"published":"2026-10-07","venue":"Obesity (Silver Spring, Md.)","cited_by":0,"doi":"10.1002/oby.70311","arxiv_id":null,"nct_id":null,"source_url":"https://doi.org/10.1002/oby.70311","archive_url":"https://space-kitty.com/papers/doi:10.1002/oby.70311","updated":null,"pmid":"42844829","pmcid":null,"openalex_id":null,"pdf_url":null,"abstract":"Objective This study aimed to evaluate the conventional and distributional cost-effectiveness of semaglutide, laparoscopic sleeve gastrectomy (LSG), and a \"do nothing\" option in Black and White racial subgroups. Methods A Markov simulation model was developed from a healthcare perspective over a 25-year time horizon for Black and White adults, aged 65-70, with BMI ≥ 35 and cardiovascular disease. Three interventions were modeled: semaglutide 2.4 mg, LSG, and \"do nothing.\" Results Semaglutide and LSG interventions are cost-effective compared to a \"do nothing\" strategy (ICERs = $7300/QALY and $12,100/QALY, respectively). Compared to semaglutide, LSG is more expensive but cost-effective (ICER = $53,700/QALY). Semaglutide is more equitable but is not distributionally cost-effective compared to LSG, because it has a lower EDE within our defined inequality aversion (ε) range. Across 10,000 probabilistic iterations, LSG has a 57% probability and semaglutide has a 43% probability of being the most cost-effective at the willingness-to-pay threshold of $100,000/QALY. Semaglutide becomes distributionally cost-effective when ε ≥ 14.72, where equity impacts of semaglutide outweigh the conventional cost-effectiveness outcomes. Conclusions LSG is the most conventionally cost-effective treatment option with some uncertainty. Semaglutide is marginally more equitable than LSG but is not a distributionally cost-effective strategy.","abstract_license":"CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)","license":"CC-BY","is_open_access":false,"retracted":false,"peer_reviewed":null,"categories":[],"details":null,"provenance":"europepmc","attribution":"Abstract of \"The Conventional Cost-Effectiveness and Distributional Cost-Effectiveness of Semaglutide for Obesity Treatment\" by Kulkarni NS, Hutton D, Rhyan C et al., https://doi.org/10.1002/oby.70311, used under its Creative Commons Attribution license (CC-BY); markup removed, otherwise unmodified.","topics":[{"slug":"glp1-metabolic","name":"GLP-1 & Incretin Therapies","domain_slug":"medicine"}],"cited_in_dossiers":[{"slug":"glp1-metabolic","title":"GLP-1 & Incretin Therapies: State of the Field (October 2026)","url":"https://space-kitty.com/dossiers/glp1-metabolic"}]}