Assessing the Cost-Effectiveness of Semaglutide 2.4 mg in the Management of People With Obesity and Knee Osteoarthritis in the UK
Author(s)
Mafalda Ramos, MSc1, Inger Smith, MSc2, Karthik Ramakrishnan, MSc3, Mark Lamotte, MD4.
1Th(is)²Modeling, Asse, Belgium, 2Novo Nordisk; White Box Health Economics Ltd, Copenhagen, Denmark, 3Novo Nordisk, Bangalore, India, 4Cardiologist - Health economic specialist, Th(is)²Modeling, Asse, Belgium.
1Th(is)²Modeling, Asse, Belgium, 2Novo Nordisk; White Box Health Economics Ltd, Copenhagen, Denmark, 3Novo Nordisk, Bangalore, India, 4Cardiologist - Health economic specialist, Th(is)²Modeling, Asse, Belgium.
OBJECTIVES: Knee osteoarthritis (KneeOA) is the most prevalent form of osteoarthritis and is a well-known complication of obesity. Guidelines recommend weight loss to alleviate KneeOA symptoms and prevent disease worsening. Semaglutide, a GLP-1 receptor agonist approved for obesity, was evaluated in patients with obesity+ KneeOA (i.e. STEP-9 trial) and showed a significant benefit in reducing KneeOA pain symptoms and weight loss. The cost-effectiveness of semaglutide with diet and exercise (D&E) versus D&E alone was assessed, in the treatment of obesity+KneeOA in the UK using STEP-9 trial data.
METHODS: The well-established and validated Core Obesity Model was adapted, sourcing utilities dependent on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores specific to people with KneeOA from the published Osteoarthritis Policy model. Baseline characteristics, changes in BMI and WOMAC scores were derived from the STEP-9 study. Time horizon was lifelong. Treatment duration of 20 years was assumed in both arms, after which treatment effects were lost. In the D&E alone arm, a natural progression of weight was applied. Long-term treatment benefits included prevention of knee replacement (KR) and obesity-related complications (ORCs). The UK healthcare payer perspective was considered using drug list prices, published costs of complications and annual discount rates of 3.5%.
RESULTS: Treatment with semaglutide reduced the incidence of KR by 6.4% and provided a QALY gain of 1.94 years for an additional cost of GBP23,108, resulting in ICER of 11,910GBP/QALY gained. Excluding the benefit of semaglutide in preventing other ORC (e.g. weight-related cancers, diabetes and cardiovascular disease) increased the ICER to 16,157GBP/QALY gained. The probabilistic sensitivity analysis showed that semaglutide is cost-effective in 100% of cases assuming a willingness-to-pay (WTP) threshold of 20,000GBP/QALY.
CONCLUSIONS: Treatment with semaglutide and D&E can be considered cost-effective versus D&E alone in people with obesity and KneeOA in the UK for a WTP threshold of 20,000GBP/QALY gained.
METHODS: The well-established and validated Core Obesity Model was adapted, sourcing utilities dependent on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores specific to people with KneeOA from the published Osteoarthritis Policy model. Baseline characteristics, changes in BMI and WOMAC scores were derived from the STEP-9 study. Time horizon was lifelong. Treatment duration of 20 years was assumed in both arms, after which treatment effects were lost. In the D&E alone arm, a natural progression of weight was applied. Long-term treatment benefits included prevention of knee replacement (KR) and obesity-related complications (ORCs). The UK healthcare payer perspective was considered using drug list prices, published costs of complications and annual discount rates of 3.5%.
RESULTS: Treatment with semaglutide reduced the incidence of KR by 6.4% and provided a QALY gain of 1.94 years for an additional cost of GBP23,108, resulting in ICER of 11,910GBP/QALY gained. Excluding the benefit of semaglutide in preventing other ORC (e.g. weight-related cancers, diabetes and cardiovascular disease) increased the ICER to 16,157GBP/QALY gained. The probabilistic sensitivity analysis showed that semaglutide is cost-effective in 100% of cases assuming a willingness-to-pay (WTP) threshold of 20,000GBP/QALY.
CONCLUSIONS: Treatment with semaglutide and D&E can be considered cost-effective versus D&E alone in people with obesity and KneeOA in the UK for a WTP threshold of 20,000GBP/QALY gained.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE59
Topic
Economic Evaluation, Methodological & Statistical Research
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)