Are Semaglutide and Tirzepatide Cost-Effective for Weight Management? A Systematic Review and Meta-analysis

Are Semaglutide and Tirzepatide Cost-Effective for Weight Management? A Systematic Review and Meta-analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Are Semaglutide and Tirzepatide Cost-Effective for Weight Management? A Systematic Review and Meta-analysis Yile Xu, Hannah E. Carter, Michelle Allen, Steven M McPhail, Qing XIA This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9709510/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The clinical effectiveness of semaglutide and tirzepatide for weight management has been well established; however, their cost-effectiveness remains uncertain. This study aims to systematically synthesise cost-effectiveness evidence for both agonists for weight management in individuals without diabetes, compared to any possible alternatives. PubMed, Embase, MEDLINE and Scopus were searched to retrieve eligible studies. Basic study characteristics, model characteristics/inputs/results were extracted. Base-case cost-effectiveness outcomes were classified as ‘dominant’, ‘cost-effective’, or ‘not cost-effective’ based on each study’s willingness-to-pay threshold. Subgroup analyses stratified by target population, treatment duration, comparator type, and sponsor type. Sensitivity analyses considered standardising costs and applying various WTP thresholds. N=34 articles (with 76 comparisons for semaglutide and 37 for tirzepatide) were included, mostly from high-income settings and from a healthcare payer perspective.Overall, semaglutide and tirzepatide were not cost-effective in 63% and 57% of comparisons, respectively. Favorable outcomes were generally observed in comparisons modelling short-term treatment. Notably, in comparisons sponsored by the respective manufacturers, both agonists were found to be either dominant or cost-effective, while dominated outcomes were only reported in comparisons without industry involvement. Additionally, both agonists were more likely to be cost-effective among populations with weight-related comorbidities. Findings remained consistent in sensitivity analyses. Current evidence did not consistently support semaglutide or tirzepatide as cost-effective interventions for weight management, particularly in the absence of robust long-term clinical data. Future independent economic evaluations with long-term clinical evidence are needed to identify the subpopulations most likely derive value from GLP-1RA therapy. Health Economics & Outcomes Research Glucagon-like peptide 1 receptor agonist Semaglutide Tirzepatide Cost-effectiveness analysis Industry sponsorship bias Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9709510","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":640043778,"identity":"7f7c0ff5-46ce-46cc-9539-265315111f3d","order_by":0,"name":"Yile Xu","email":"","orcid":"","institution":"Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health \u0026 Social Work, Queensland University of Technology (QUT)","correspondingAuthor":false,"prefix":"","firstName":"Yile","middleName":"","lastName":"Xu","suffix":""},{"id":640043779,"identity":"1370e885-764e-45fb-ae4c-4c4cc5c9a253","order_by":1,"name":"Hannah E. 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This study aims to systematically synthesise cost-effectiveness evidence for both agonists for weight management in individuals without diabetes, compared to any possible alternatives.\u003c/p\u003e\n\u003cp\u003ePubMed, Embase, MEDLINE and Scopus were searched to retrieve eligible studies. Basic study characteristics, model characteristics/inputs/results were extracted. Base-case cost-effectiveness outcomes were classified as ‘dominant’, ‘cost-effective’, or ‘not cost-effective’ based on each study’s willingness-to-pay threshold. Subgroup analyses stratified by target population, treatment duration, comparator type, and sponsor type. 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