{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:54:00Z","timestamp":1791438840062,"version":"4.3.3"},"reference-count":45,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the conventional and distributional cost\u2010effectiveness of semaglutide, laparoscopic sleeve gastrectomy (LSG), and a \u201cdo nothing\u201d option in Black and White racial subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Markov simulation model was developed from a healthcare perspective over a 25\u2010year time horizon for Black and White adults, aged 65\u201370, with BMI \u2265\u200935 and cardiovascular disease. Three interventions were modeled: semaglutide 2.4\u2009mg, LSG, and \u201cdo nothing.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Semaglutide and LSG interventions are cost\u2010effective compared to a \u201cdo nothing\u201d strategy (ICERs\u2009=\u2009$7300\/QALY and $12,100\/QALY, respectively). Compared to semaglutide, LSG is more expensive but cost\u2010effective (ICER\u2009=\u2009$53,700\/QALY). Semaglutide is more equitable but is not distributionally cost\u2010effective compared to LSG, because it has a lower EDE within our defined inequality aversion (\n                      <jats:italic>\u03b5<\/jats:italic>\n                      ) range. Across 10,000 probabilistic iterations, LSG has a 57% probability and semaglutide has a 43% probability of being the most cost\u2010effective at the willingness\u2010to\u2010pay threshold of $100,000\/QALY. Semaglutide becomes distributionally cost\u2010effective when\n                      <jats:italic>\u03b5<\/jats:italic>\n                      \u2009\u2265\u200914.72, where equity impacts of semaglutide outweigh the conventional cost\u2010effectiveness outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LSG is the most conventionally cost\u2010effective treatment option with some uncertainty. Semaglutide is marginally more equitable than LSG but is not a distributionally cost\u2010effective strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oby.70311","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:24:52Z","timestamp":1791437092000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Conventional Cost\u2010Effectiveness and Distributional Cost\u2010Effectiveness of Semaglutide for Obesity Treatment"],"prefix":"10.1002","author":[{"given":"Neeti S.","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Department of Health Management and Policy University of Michigan School of Public Health  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9677-1632","authenticated-orcid":false,"given":"David","family":"Hutton","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy University of Michigan School of Public Health  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corwin","family":"Rhyan","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy University of Michigan School of Public Health  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S.","family":"McCullough","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy University of Michigan School of Public Health  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2684-2040","authenticated-orcid":false,"given":"Michaela","family":"Greenlee","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6130-2286","authenticated-orcid":false,"given":"Ankur","family":"Pandya","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"The White House \u201cFact Sheet: President Donald J. 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