{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T08:17:54Z","timestamp":1781079474428,"version":"3.54.1"},"reference-count":56,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"\n Importance<\/jats:title>\n Semaglutide reduces the risk of major adverse cardiovascular events (MACE) in adults with overweight or obesity and cardiovascular disease (CVD) but without diabetes. The cost-effectiveness and budget impact of semaglutide therapy could inform ongoing Medicare price negotiations but are uncertain.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the cost-effectiveness of semaglutide for secondary prevention of CVD and potential effect on US health care spending.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based cohort simulation study used the CVD Policy Model, a validated simulation model of CVD outcomes and costs in the US, to evaluate lifetime cost-effectiveness of semaglutide. The addition of lifetime treatment with weekly subcutaneous semaglutide to usual care compared with usual care alone in US adults age 45 years or older, with a body mass index (calculated as weight in kilograms divided by height in meters squared) of 27 or higher, and history of myocardial infarction or stroke, without diabetes were evaluated. The model incorporated annual semaglutide cost of $8604 (2023 US price net of rebates and discounts) and adopted a health-system perspective. Sensitivity analyses explored uncertainty. These data were analyzed from January 2024 and June 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Semaglutide and usual care compared with usual care alone.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Main outcomes were lifetime MACE (cardiovascular death, myocardial infarction, or stroke), incremental cost per quality-adjusted life-year (QALY), and change in annual US health care spending.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Adding semaglutide to usual care in the estimated 4 million US adults without diabetes eligible for secondary prevention of CVD is projected to avert 358\u202f400 MACE at a cost of $148\u202f100 per QALY gained (95% uncertainty interval, $127\u202f100-$173\u202f400). The mean age of this cohort was 66 years and 55% were male and 45% were female. Treatment with semaglutide was projected to increase annual health care spending by $23 billion. Semaglutide would be cost-effective at a threshold of $120\u202f000 per QALY gained if the annual cost were lowered an additional 18% to $7055. Semaglutide is cost-effective for this indication at the cash price currently available to self-paying customers ($5988; incremental cost-effectiveness ratio, $99\u202f600 per QALY gained).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Semaglutide for secondary prevention of CVD in US adults with overweight or obesity but without diabetes is projected to yield meaningful health benefits. Lowering annual drug costs by 18% from $8604 to $7055\u2014or making the current cash price available to all patients\u2014would make semaglutide cost-effective at $120\u202f000 per QALY gained.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamacardio.2025.5243","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T16:30:45Z","timestamp":1770222645000},"page":"229","source":"Crossref","is-referenced-by-count":6,"title":["Cost-Effectiveness of Semaglutide for Secondary Prevention of Cardiovascular Disease in US Adults"],"prefix":"10.1001","volume":"11","author":[{"given":"Susan","family":"Hennessy","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Penko","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon K.","family":"Bellows","sequence":"additional","affiliation":[{"name":"College of Physicians and Surgeons, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela G.","family":"Coxson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Boylan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendra D.","family":"Sims","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"},{"name":"Boston University School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Beatty","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"},{"name":"Division of Cardiology, Department of Medicine, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Inoue","sequence":"additional","affiliation":[{"name":"Richard A. and Susan F. 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