# The Conventional Cost-Effectiveness and Distributional Cost-Effectiveness of Semaglutide for Obesity Treatment

Article · Kulkarni NS, Hutton D, Rhyan C, McCullough JS, Greenlee M, Pandya A

- Archive id: doi:10.1002/oby.70311
- Published: 2026-10-07
- Venue: Obesity (Silver Spring, Md.)
- DOI: https://doi.org/10.1002/oby.70311
- PMID: 42844829
- Citations: 0
- Source URL: https://doi.org/10.1002/oby.70311
- Provenance: europepmc

## 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 reproduced under CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)._

Topics: [GLP-1 & Incretin Therapies](https://space-kitty.com/topics/glp1-metabolic)

Cited in dossiers:
- [GLP-1 & Incretin Therapies: State of the Field (October 2026)](https://space-kitty.com/dossiers/glp1-metabolic)

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