Presentation (CTI)

OBJECTIVES: To evaluate the long-term cost-utility of GLP-1 receptor agonists (GLP-1 RAs) compared with standard care in patients with Cardiovascular-Kidney-Metabolic (CKM) syndrome, considering multisystem benefits on metabolic, cardiovascular, renal, and weight-related outcomes.
METHODS: A cost-utility analysis using Markov model to simulate disease progression in patients with CKM syndrome. The model compared GLP-1 RAs with standard care versus standard care alone over a lifetime period from the healthcare payer perspective. Health outcomes measures were expressed in quality-adjusted life years (QALYs), and costs in 2024 USD. Incremental cost-effectiveness ratios (ICERs) are calculated. A discounting of 3% annually applied to both costs and outcomes. Deterministic and probabilistic sensitivity analysis are conducted to assess uncertainty of results. A budget impact analysis evaluated affordability at the population level.
RESULTS: GLP-1 RA therapy resulted in increased lifetime QALYs through curtailment in major adverse cardiovascular events, delayed progression to type 2 diabetes and chronic kidney disease, and sustained weight loss with associated quality-of-life improvements. Although the acquisition of GLP-1 RAs increased drug costs, these were partially offset by reductions in subsequent costs related to cardiovascular events, renal failure, and obesity-related comorbidities. The resulting ICER is within the range of the commonly accepted willingness-to-pay thresholds. Budget impact analysis indicated substantial short-term financial burden due to the large eligible population.
CONCLUSIONS: Over a lifetime horizon, GLP-1 RAs were represented as a cost-effective preventive strategy for CKM syndrome but the large-scale implementation would lead to significant affordability challenges. Policymakers should consider risk-stratified access and value-based pricing approaches to optimize both efficiency and budget sustainability, to capture the long-term preventive benefits of GLP-1 RAs.