Which is cheaper, liraglutide or Ozempic (semaglutide), for an adult patient with type 2 diabetes or obesity?

Cost Comparison: Liraglutide vs Ozempic (Semaglutide)

Ozempic (semaglutide) provides significantly better value for money than liraglutide, with a cost needed to treat per 1% body weight reduction of $1,845 compared to $3,256 for liraglutide, despite higher upfront medication costs. 1

Direct Medication Cost Analysis

Retail Pricing

• Liraglutide (Saxenda 3.0mg daily) costs approximately $1,619 per 30-day supply at average wholesale price 2
• Ozempic (semaglutide 1mg weekly) costs approximately $1,600 per 30-day supply at average wholesale price 2
• Wegovy (semaglutide 2.4mg weekly) costs approximately $1,557-$1,619 per 30-day supply at average wholesale price 2

The monthly acquisition costs are essentially equivalent between the two medications, with both ranging from $1,600-$1,619 per month 2. However, this superficial price parity masks substantial differences in cost-effectiveness.

Cost-Effectiveness Analysis

Value Per Unit of Weight Loss

• Semaglutide delivers superior cost-effectiveness with an incremental cost-effectiveness ratio (ICER) of $7,056 per patient per 68 weeks for achieving ≥15% weight loss 3
• Semaglutide costs $1,845 per 1% body weight reduction (95% CI: $1,707-$1,989) compared to liraglutide's $3,256 per 1% (95% CI: $3,032-$3,517) 1
• This represents a 43% better value with semaglutide despite similar monthly costs 1

Clinical Efficacy Driving Cost-Effectiveness

• Semaglutide 2.4mg weekly achieves 15.8% mean weight loss at 68 weeks versus liraglutide 3.0mg daily achieving only 6.4% 4
• Oral semaglutide versus liraglutide has a cost per QALY gained of $42,000, with 98% probability of being cost-effective at $156,000 willingness-to-pay threshold 5
• 70.9% of patients on semaglutide achieve ≥10% weight loss versus only 25.6% on liraglutide (odds ratio 6.3,95% CI 3.5-11.2) 4

Long-Term Economic Considerations

Reduced Complication Costs

• Oral semaglutide reduces direct complication costs by £187 per person compared to liraglutide due to fewer diabetes-related complications 6
• Semaglutide provides 0.18 additional quality-adjusted life years versus liraglutide, driven by reduced cardiovascular events and lower treatment burden 6
• Semaglutide remains cost-effective even with 50% price reductions applied to liraglutide, demonstrating robust economic superiority 6

Treatment Persistence and Adherence

• Treatment discontinuation rates are lower with semaglutide (13.5%) compared to liraglutide (27.6%), reducing costs associated with treatment switching 4
• Once-weekly dosing with semaglutide versus once-daily liraglutide injections improves adherence and reduces administration burden 6

Critical Nuances in Cost Comparison

Sensitivity to Price Changes

• The cost-effectiveness model remains robust against 50% increases in semaglutide unit cost and 50% decreases in liraglutide unit cost 3
• Even at substantially reduced liraglutide prices, semaglutide maintains cost-effectiveness due to superior clinical outcomes 6

Type 2 Diabetes Context

• For patients with type 2 diabetes, both medications cost approximately $1,272-$1,619 per month, but semaglutide provides superior HbA1c reduction (1.48% vs 1.4%) and greater weight loss 2
• Semaglutide demonstrates proven cardiovascular benefit with 26% reduction in major adverse cardiovascular events (HR 0.74,95% CI 0.58-0.95), potentially reducing long-term healthcare costs 2

Common Pitfalls to Avoid

• Do not focus solely on monthly acquisition costs when comparing these medications—the superior efficacy of semaglutide translates to better value despite similar upfront pricing 1
• Do not assume generic or lower-cost liraglutide formulations automatically provide better value—economic modeling shows semaglutide remains cost-effective even with 50% liraglutide price reductions 6
• Do not ignore treatment discontinuation rates—liraglutide's higher discontinuation rate (27.6% vs 13.5%) adds hidden costs from treatment switching and reduced effectiveness 4

Bottom Line for Clinical Decision-Making

While monthly medication costs are nearly identical ($1,600-$1,619), semaglutide delivers substantially better value through:

• 2.5-fold greater weight loss (15.8% vs 6.4%) 4
• 43% lower cost per unit of weight loss ($1,845 vs $3,256 per 1% reduction) 1
• Lower treatment discontinuation rates (13.5% vs 27.6%) 4
• Proven cardiovascular benefit reducing long-term complication costs 2

For patients requiring maximum weight loss or with established cardiovascular disease, semaglutide represents the more cost-effective choice despite equivalent monthly pricing. 1, 4, 6