Impact of semaglutide 2.4 mg on healthcare resource utilization and medical costs in patients with atherosclerotic cardiovascular disease in the United States (SHINE-ASCVD)
- PMID: 40579810
- DOI: 10.1080/13696998.2025.2526282
Impact of semaglutide 2.4 mg on healthcare resource utilization and medical costs in patients with atherosclerotic cardiovascular disease in the United States (SHINE-ASCVD)
Abstract
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.
Keywords: Atherosclerotic cardiovascular disease; I00; I10; costs; healthcare resource utilization; obesity; semaglutide.
Plain language summary
People with overweight or obesity have an increased risk for atherosclerotic cardiovascular disease (ASCVD), including heart attack, stroke, or pain, numbness, or weakness in the arms or legs. It is a leading cause of death in the United States and, in addition to the high clinical burden and decreased quality of life for patients, ASCVD poses a significant burden to healthcare systems as one of the costliest consequences of excess weight.In this database study, we analyzed data from routine, real-world clinical practice involving patients with overweight or obesity and ASCVD who were treated with semaglutide 2.4 mg. Use of healthcare resources, including hospitalizations, emergency department [ED] visits, and outpatient visits (e.g. office visits, blood draws, physical therapy) and medical costs were compared with patients with similar clinical and demographic characteristics who did not receive semaglutide 2.4 mg (controls).In the year following treatment initiation, semaglutide 2.4 mg-treated patients had 22% lower average total medical costs ($16,201 vs. $20,840), 65% lower average hospitalization costs ($1,955 vs. $5,548), and on average, experienced fewer hospitalizations (0.08 vs. 0.15) compared with controls. This study adds to the positive clinical outcomes demonstrated with semaglutide 2.4 mg in clinical trials and real-world studies and shows its economic value in treating patients with overweight or obesity and ASCVD. Lower costs and healthcare resource use with semaglutide 2.4 mg may help to slow the growing economic burden of ASCVD in these patients.
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