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Multidisciplinary Approach to Obesity Management: A Case Report
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Changes in Cardiovascular Risk Factors and Health Care Expenditures Among Patients Prescribed Semaglutide.
Yuan Lu1,2,3, Yuntian Liu2,3, Tedi Totojani4
1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
JAMA Network Open
|August 8, 2025
Summary
Semaglutide use in adults led to significant weight and cardiovascular risk factor reductions. However, healthcare costs, excluding medication, increased, necessitating further economic impact evaluation.
Area of Science:
- Pharmacology and Endocrinology
- Cardiovascular Medicine
- Health Economics
Background:
- Semaglutide, a GLP-1 receptor agonist, shows promise for weight reduction and cardiovascular benefits.
- Real-world data on semaglutide's impact on clinical outcomes and healthcare expenditures are limited.
Purpose of the Study:
- To assess changes in cardiovascular risk factors and healthcare expenditures in patients prescribed semaglutide.
- To evaluate these outcomes across multicenter cohorts in a real-world setting.
Main Methods:
- Retrospective cohort study of 23,522 adults receiving initial semaglutide prescriptions.
- Staggered difference-in-differences design comparing outcomes before and after semaglutide initiation.
- Primary outcomes: weight, blood pressure, total cholesterol, HbA1c. Secondary outcomes: healthcare expenditures.
Main Results:
- Semaglutide initiation associated with significant reductions in weight (-3.8%), systolic BP (-1.1 mmHg), diastolic BP (-1.5 mmHg), and total cholesterol (-12.8 mg/dL).
- HbA1c reductions observed, greater in patients with diabetes (-0.3%).
- Excluding semaglutide costs, healthcare expenditures increased by $80/month, linked to inpatient stays for circulatory/metabolic issues.
Conclusions:
- Semaglutide initiation demonstrates clinical benefits, including weight loss and improved cardiovascular risk factors.
- A notable increase in healthcare expenditures, independent of drug cost, warrants further investigation.
- Long-term economic impact evaluation is crucial for understanding semaglutide's overall value.
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