JAMA Netw Open

Semaglutide lowers CV risk but raises health care costs

August 13, 2025

Study details: This retrospective cohort study analyzed 23,522 adults (mean age, 56.2 years; 66.7% female) prescribed semaglutide between 2018 and 2025 across two large U.S. health systems. Using a staggered difference-in-differences design, researchers assessed changes in CV risk factors and health care expenditures before and after semaglutide initiation, stratified by diabetes status.

Results: Semaglutide was associated with a 3.8% average weight reduction at 13 to 24 months (confidence interval [CI], −3.9% to −3.7%), with greater reductions in patients without diabetes (−5.1%; CI, −5.5% to −4.7%). Additional improvements included:

• Systolic BP (−1.1 mm Hg) and diastolic BP (−1.5 mm Hg)
• Total cholesterol (−12.8 mg/dL)
• HbA1c (−0.3%) in patients with diabetes

However, monthly health care expenditures—excluding semaglutide costs—increased by $80, driven mainly by inpatient stays shifting to more expensive circulatory and metabolic diagnoses.

Clinical impact: Semaglutide improves CV risk profiles in real-world settings, supporting its use in both diabetic and non-diabetic populations. The associated rise in health care costs warrants further evaluation of long-term cost-effectiveness.

Source:

Lu Y, et al. (2025, August 1). JAMA Netw Open. Changes in Cardiovascular Risk Factors and Health Care Expenditures Among Patients Prescribed Semaglutide. https://pubmed.ncbi.nlm.nih.gov/40779264/