A population-based cohort simulation study using the validated CVD Policy Model evaluated the lifetime cost-effectiveness of adding weekly subcutaneous semaglutide to usual care for secondary prevention of cardiovascular disease (CVD) in US adults without diabetes. Eligible individuals were aged 45 years or older, had a body mass index of 27 or higher, and a history of myocardial infarction or stroke. The modeled cohort represented approximately 4 million US adults (mean age 66 years; 55% male, 45% female). The results were published in the JAMA Cardiology.

At an annual semaglutide cost of $8604 (2023 US price net of rebates and discounts), addition of semaglutide was projected to avert 358,400 major adverse cardiovascular events (MACE: cardiovascular death, myocardial infarction, or stroke) over a lifetime horizon. The incremental cost-effectiveness ratio (ICER) was $148,100 per quality-adjusted life-year (QALY) gained (95% uncertainty interval, $127,100–$173,400). Annual US health care spending was projected to increase by $23 billion.

Semaglutide would meet a $120,000 per QALY threshold if the annual cost were reduced by 18% to $7055. At the currently available cash price of $5988, the ICER was $99,600 per QALY gained.

Semaglutide for secondary CVD prevention in overweight or obese US adults without diabetes was projected to avert substantial MACE events. Cost reductions of 18% or broader access to current cash pricing would meet commonly cited cost-effectiveness thresholds.