Wojciech Michalak, Zhenxiang Zhao, Mads Faurby, Sara Alvarez, Angela Fitch
{"title":"西马鲁肽2.4 mg对美国动脉粥样硬化性心血管疾病（SHINE-ASCVD）患者医疗资源利用和医疗费用的影响","authors":"Wojciech Michalak, Zhenxiang Zhao, Mads Faurby, Sara Alvarez, Angela Fitch","doi":"10.1080/13696998.2025.2526282","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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]).</p><p><strong>Limitations: </strong>Limitations inherent to retrospective claims analyses apply to this study.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16229,"journal":{"name":"Journal of Medical Economics","volume":" ","pages":"1075-1085"},"PeriodicalIF":3.0000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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).\",\"authors\":\"Wojciech Michalak, Zhenxiang Zhao, Mads Faurby, Sara Alvarez, Angela Fitch\",\"doi\":\"10.1080/13696998.2025.2526282\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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]).</p><p><strong>Limitations: </strong>Limitations inherent to retrospective claims analyses apply to this study.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":16229,\"journal\":{\"name\":\"Journal of Medical Economics\",\"volume\":\" \",\"pages\":\"1075-1085\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medical Economics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/13696998.2025.2526282\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Economics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13696998.2025.2526282","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
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).
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.
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Journal of Medical Economics publishes high-quality economic assessments of novel therapeutic and device interventions for an international audience
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