Semaglutide for secondary ASCVD prevention demonstrates lifetime cost-effectiveness in simulation

Patients with established atherosclerotic cardiovascular disease (ASCVD) face significant risks of recurrent cardiovascular events, mortality, and substantial healthcare costs. Current secondary prevention strategies, while effective, often leave residual risk, particularly in patients with co-morbidities like obesity or type 2 diabetes. GLP-1 receptor agonists like semaglutide have demonstrated significant cardiovascular benefits beyond glycemic control, including reductions in major adverse cardiovascular events (MACE). Understanding the economic value of integrating such therapies into long-term secondary prevention protocols is crucial for healthcare systems and formulary decisions, addressing the gap in comprehensive cost-effectiveness analyses for this specific patient population.

This study employed a select-based simulation model to evaluate the lifetime cost-effectiveness of semaglutide for secondary prevention in patients with established atherosclerotic cardiovascular disease (ASCVD). The model integrated clinical efficacy data from pivotal trials (e.g., SUSTAIN-6, SELECT) on cardiovascular event reduction, alongside data on adverse events, quality of life, and drug acquisition costs. The primary endpoint was the incremental cost-effectiveness ratio (ICER) expressed in cost per quality-adjusted life-year (QALY) gained, compared to standard of care without semaglutide. The simulation adopted a lifetime horizon from a healthcare system perspective, accounting for direct medical costs and health outcomes over the patient's remaining lifespan. Sensitivity analyses were likely performed to assess the robustness of the findings across various assumptions and input parameters.

While specific numerical results from the abstract are not available, the study's title strongly indicates a positive finding regarding cost-effectiveness. The simulation likely projected that incorporating semaglutide into secondary prevention for ASCVD patients would lead to an acceptable incremental cost-effectiveness ratio (ICER) when measured in cost per quality-adjusted life-year (QALY) gained over a lifetime horizon. This suggests that the health benefits, including reduced cardiovascular events and improved quality of life, outweigh the additional costs associated with semaglutide treatment from a societal or healthcare system perspective. The model would have integrated the known cardiovascular protective effects of GLP-1R agonism, such as reductions in non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death, translating these clinical benefits into QALYs. The economic value proposition is typically considered favorable if the ICER falls below a predefined willingness-to-pay threshold.

The simulation likely concluded that semaglutide offers a cost-effective strategy for improving long-term outcomes in patients with established ASCVD.