Key Points:
- Effective – Wegovy Zepbound improves weight loss and health.
- Cost-efficient – Offers long-term healthcare savings.
- Budget risk – Widespread use may exceed spending limits.
Draft report highlights clinical benefits alongside affordability challenges for popular obesity medications. The Institute for Clinical and Economic Review (ICER) has released a draft evidence report evaluating the effectiveness and value of Wegovy Zepbound, Novo Nordisk’s semaglutide (Wegovy), and Eli Lilly’s tirzepatide (Zepbound) for obesity management. The review concluded that while the medications are clinically effective and cost-efficient compared to lifestyle modifications alone, their widespread use could overwhelm healthcare budgets.
Clinical benefits confirmed in cost-effectiveness analysis
ICER analyzed Novo Nordisk’s injectable semaglutide at the 2.4 mg dose, its investigational oral semaglutide 25 mg dose, and Eli Lilly’s injectable 15 mg dose of tirzepatide. The review found that all three options provided greater benefits than lifestyle interventions alone, including improved weight loss, reduced metabolic risk factors, and better management of obesity-related complications.
The report emphasized that Wegovy Zepbound is “highly certain” to deliver substantial net health benefits. At current prices, their incremental cost-effectiveness ratios fell below widely accepted thresholds. ICER noted that although the drugs increased short-term intervention costs, they could lead to long-term healthcare savings by reducing complications linked to obesity.
However, distinctions between treatments emerged. Tirzepatide received a “promising but inconclusive” designation when compared with semaglutide, reflecting some uncertainties in outcomes. Meanwhile, the oral version of semaglutide was deemed “comparable or worse” than the injectable version, due to lower weight loss results and questions about cardiovascular risk reduction.
Affordability remains the key obstacle
Despite the encouraging clinical findings, ICER expressed “serious concerns” about affordability. The report estimated the annual cost for semaglutide at $6,829, down from $13,618 in a 2022 model, while tirzepatide was projected at $7,973 per year. Even at these reduced prices, ICER warned that fewer than 1% of eligible patients could be treated before total spending surpassed its budget impact threshold of $880 million annually.
The affordability concern underscores the growing tension between breakthrough therapies and sustainable healthcare financing. While the drugs could transform obesity management, their widespread use may create significant financial strain for payers and healthcare systems.
ICER is accepting public comments on the draft report until October 6 and plans to convene a virtual public meeting in November to discuss the findings. Final recommendations are expected to help guide payers, clinicians, and policymakers in determining how best to balance clinical value with budgetary realities for Wegovy Zepbound.
