ISPOR 2026
Sunday, May 17 - Wednesday, May 20
COST-EFFECTIVENESS OF SEMAGLUTIDE FOR THE TREATMENT OF METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE IN THE UNITED STATES
Author(s)
Muhammed Rashid, PhD1, Jeong-Yeon Cho, PharmD, PhD2, Pochamana Phisalprapa, MSc, PhD, MD3, Nathorn Chaiyakunapruk, PharmD, PhD2;
1University of Utah, Post-Doctoral Research Associate, Salt Lake City, UT, USA, 2University of Utah, Salt Lake City, UT, USA, 3Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahid, Bangkok Noi, Thailand
1University of Utah, Post-Doctoral Research Associate, Salt Lake City, UT, USA, 2University of Utah, Salt Lake City, UT, USA, 3Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahid, Bangkok Noi, Thailand
OBJECTIVES: Semaglutide is shown to improve metabolic and liver-related outcomes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, the economic value of semaglutide in MASLD treatment in the U.S. remains uncertain. This study aims to evaluate the cost-effectiveness of semaglutide vs usual care for treating MASLD patients with moderate or advanced hepatic fibrosis (specifically, fibrosis stage 2 to 3) in the U.S. from a healthcare system perspective.
METHODS: A state-transition Markov model were adapted to estimate the incremental cost-effectiveness ratios (ICERs), quality-adjusted life years (QALYs), and cost (2024 USD) associated with semaglutide treatment compared to usual care over a lifetime horizon. This analysis was modeled after a hypothetical U.S. cohort of MASLD patients with moderate or advanced hepatic fibrosis from a healthcare system perspective. Multiple health states including fibrosis, cirrhosis, hepatocellular carcinoma (HCC), liver transplantation, post-transplantation and death were considered. The input parameters were derived from the published literature. Both cost and outcome were discounted at an annual rate of 3%. A series of sensitivity analyses were performed to assess robustness of the findings. A Cost-effectiveness Acceptability Curve illustrated the probability of being cost-effective across willingness-to-pay (WTP) thresholds.
RESULTS: In the base case analysis, semaglutide treatment is projected to prevent 252 decompensated cirrhosis cases and 131 HCC cases per 10,000 patients over the lifetime. Treatment with semaglutide was associated with an additional 0.21 QALYs compared to usual care with an incremental cost of $18,135; resulting in an ICER of $87,776 per QALY. Semaglutide had a 63% probability of being cost-effective at a WTP of $100,000 per QALY, with corresponding probabilities of 89% and 95% at $150,000 and $200,000 per QALY, respectively.
CONCLUSIONS: Semaglutide is likely to be cost-effective in MASLD patients with moderate or advanced hepatic fibrosis. These findings support inclusion of semaglutide in MASLD management strategy and clinical practice guideline.
METHODS: A state-transition Markov model were adapted to estimate the incremental cost-effectiveness ratios (ICERs), quality-adjusted life years (QALYs), and cost (2024 USD) associated with semaglutide treatment compared to usual care over a lifetime horizon. This analysis was modeled after a hypothetical U.S. cohort of MASLD patients with moderate or advanced hepatic fibrosis from a healthcare system perspective. Multiple health states including fibrosis, cirrhosis, hepatocellular carcinoma (HCC), liver transplantation, post-transplantation and death were considered. The input parameters were derived from the published literature. Both cost and outcome were discounted at an annual rate of 3%. A series of sensitivity analyses were performed to assess robustness of the findings. A Cost-effectiveness Acceptability Curve illustrated the probability of being cost-effective across willingness-to-pay (WTP) thresholds.
RESULTS: In the base case analysis, semaglutide treatment is projected to prevent 252 decompensated cirrhosis cases and 131 HCC cases per 10,000 patients over the lifetime. Treatment with semaglutide was associated with an additional 0.21 QALYs compared to usual care with an incremental cost of $18,135; resulting in an ICER of $87,776 per QALY. Semaglutide had a 63% probability of being cost-effective at a WTP of $100,000 per QALY, with corresponding probabilities of 89% and 95% at $150,000 and $200,000 per QALY, respectively.
CONCLUSIONS: Semaglutide is likely to be cost-effective in MASLD patients with moderate or advanced hepatic fibrosis. These findings support inclusion of semaglutide in MASLD management strategy and clinical practice guideline.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE439
Topic
Economic Evaluation
Disease
SDC: Gastrointestinal Disorders