What is the cost of semaglutide (glucagon-like peptide-1 receptor agonist) for a patient with metabolic syndrome?

Cost of Semaglutide for Patients with Metabolic Syndrome

The cost of semaglutide for patients with metabolic syndrome in the United States ranges from approximately $667 to $1,871 per year, with most recent estimates indicating annual costs of around $22,878 for the weight loss formulation. 1

Cost Breakdown by Formulation

Weight Management Formulation (Higher Dose)

• Total cost of semaglutide therapy for weight reduction: approximately $22,878 per year 1
• Cost per 1% body weight reduction: $1,845 (95% CI: $1,707-$1,989) 1
• This represents better value for money compared to liraglutide, which costs $3,256 per 1% body weight reduction 1

Type 2 Diabetes Formulation

• In China, appropriate annual cost ranges between $667.04 and $877.43 2
• In the US, costs are significantly higher
• For oral semaglutide in China, the estimated annual cost is around $1,711.03 to be cost-effective compared to placebo 3

Cost-Effectiveness Considerations

For Metabolic Syndrome/Obesity

• Semaglutide 2.4mg for obesity with cardiovascular disease has:
  • Average per-subject lifetime treatment costs: $47,353 4
  • Incremental cost-effectiveness ratio (ICER): $136,271/QALY at list price 4
  • With estimated 48% rebate: $32,219/QALY 4

For Type 2 Diabetes

• Oral semaglutide added to existing diabetes treatment:
  • Lifetime total cost: $311,300 5
  • More cost-effective compared to liraglutide (ICER = $40,100/QALY) 5
  • Moderately cost-effective versus background treatment alone (ICER = $117,500/QALY) 5

Cost Savings Potential

When considering lifetime costs, semaglutide may generate savings through:

• Avoided Type 2 diabetes development: $14,431 per patient 4
• Reduced chronic kidney disease: $2,074 per patient 4
• Avoided cardiovascular events: $1,512 per patient 4

Common Pitfalls in Cost Consideration

1. Focusing only on upfront costs: While initial medication costs are high, long-term savings from prevented complications may offset these expenses
2. Ignoring insurance coverage: Out-of-pocket costs vary significantly based on insurance plans
3. Not considering patient assistance programs: Manufacturer programs may reduce costs for eligible patients
4. Overlooking comparative value: Despite high absolute costs, semaglutide provides better value per percentage of weight loss compared to alternatives like liraglutide 1

Clinical Implications for Patients with Metabolic Syndrome

For patients with metabolic syndrome specifically:

• The high cost may be justified by significant weight reduction (12.4% average) 1
• Cardiovascular benefits may further justify costs, especially in high-risk patients 4
• Consider cost-effectiveness when selecting between GLP-1 receptor agonists (semaglutide shows better value for weight reduction than liraglutide) 1