Impact of Semaglutide 2.4 mg on Healthcare Resource Utilization and Medical Costs in Patients With Heart Failure in the United States (SHINE-HF)

Purpose

Obesity is a risk factor for premature development of heart failure (HF), one of the costliest obesity-related disorders. Clinical trials have demonstrated the efficacy of semaglutide 2.4 mg in improving outcomes in patients with HF. The study objective is to compare total all-cause medical costs and healthcare resource utilization (HCRU) among patients with overweight or obesity and HF treated with semaglutide 2.4 mg versus those not treated.

Methods

This retrospective, noninterventional, cohort study using the Komodo Healthcare Map© included patients with ≥1 inpatient or outpatient claim for HF during the baseline period, with overweight or obesity, and ≥12 months of continuous medical and pharmacy enrollment prior to and after the index date. Patients were included in the treated group if they first filled a prescription for semaglutide 2.4 mg between June 4, 2021-September 30, 2023. Semaglutide-untreated controls were randomly selected and propensity score matched to treated patients based on baseline demographics, clinical characteristics, medical costs, and HCRU. Medical costs and HCRU rates were compared using generalized linear models with a quasi-Poisson distribution.

Findings

In the year following treatment initiation with semaglutide 2.4 mg, mean all-cause medical costs were 28% lower (–$8,544) compared with patients not treated with semaglutide 2.4 mg ($19,094 vs $27,638 per patient per year [PPPY]; adjusted cost ratio [aCR] = 0.72, 95% confidence interval [CI] 0.60–0.84]; P < 0.001). Inpatient costs with semaglutide 2.4 mg were 55% lower (–$6,304) than controls ($4,377 vs $10,681; aCR = 0.45 [95% CI 0.26–0.64]; P < 0.001) and the inpatient visit rate PPPY was 42% lower in treated patients versus controls (0.15 vs. 0.26; adjusted inpatient visit rate ratio = 0.58 [95% CI 0.38–0.78]; P < 0.001). The mean outpatient visit rate was higher in the semaglutide 2.4 mg-treated group (36.6 vs. 31.6; P = 0.027), but outpatient costs were slightly lower ($13,366 vs. $15,654; aCR = 0.88; 95% CI 0.74–1.03; P = 0.11) with semaglutide 2.4 mg, indicating more frequent outpatient services, but at a lower intensity level. No difference was found in emergency department costs or visit rates.

Implications

This real-world analysis of a large, US administrative claims database shows significantly lower medical costs and inpatient resource utilization among patients treated with semaglutide 2.4 mg with overweight or obesity and HF compared with those who did not receive semaglutide 2.4 mg. Improving outcomes with semaglutide 2.4 mg in these patients combined with lower costs and HCRU can help to manage the growing burden of HF to the US.