GLP-1 RAs Cost-Effective Versus Usual Care for Knee OA, Obesity
WEDNESDAY, Sept. 17, 2025 -- Compared with usual care, the glucagon-like peptide 1 receptor agonists (GLP-1 RAs) tirzepatide and semaglutide are cost-effective for people with knee osteoarthritis (OA) and obesity, according to a study published online Sept. 16 in Annals of Internal Medicine.
Daniel J. Betensky, from Brigham and Women's Hospital in Boston, and colleagues examined the cost-effectiveness of semaglutide and tirzepatide for patients with knee osteoarthritis and obesity. The base-case cohort included patients with a Western Ontario and McMaster Universities Osteoarthritis Index pain score of 71 and mean body mass index (BMI) of 40 kg/m2.
The researchers found that in the base-case analysis, tirzepatide provided greater health benefits at lower costs than semaglutide, and compared with diet and exercise, tirzepatide yielded a $57,400 per quality-adjusted life year (QALY) incremental cost-effectiveness ratio (ICER). Compared with the two GLP-1 RAs, for those eligible, Roux-en-Y gastric bypass (RYGB) provided greater health benefits at lower costs and had a $30,700 per QALY ICER compared with laparoscopic sleeve gastrectomy. Tirzepatide's ICER was most sensitive to changes in medication costs, treatment efficacy, and baseline BMI in the sensitivity analysis. The probability of being cost-effective at a $100,000 per QALY threshold was 64 percent for tirzepatide and 34 percent for semaglutide.
"Clinicians may consider discussing the differences between these weight loss interventions, their potential benefits and harms, and currently available knee osteoarthritis care options with their eligible patients," the authors write.
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