ADULTS prescribed semaglutide showed notable improvements in cardiovascular risk factors, including reduced weight, blood pressure, cholesterol and blood sugar levels, according to a large multicentre cohort study. However, these health gains were accompanied by an unexpected rise in overall health care expenditures, excluding the cost of the drug itself.
Semaglutide, a glucagon-like peptide-1 receptor agonist, is widely used for type 2 diabetes management and weight reduction, with mounting evidence of its cardiovascular benefits. Yet, little is known about its real-world impact on clinical risk factors and health service costs beyond regulatory trial settings. This latest investigation aimed to determine the effects of semaglutide on both health profiles and health care utilisation across a diverse adult population.
Researchers analysed the records of 23,522 adults initiating semaglutide between 2018 and 2025 at two major health systems, with two-thirds of participants having diabetes at baseline. At 13 to 24 months following prescription, participants experienced a 3.8 per cent drop from baseline weight, with those without diabetes seeing even greater reductions of 5.1 per cent. Diastolic blood pressure decreased by 1.5mm Hg, systolic by 1.1mm Hg, and total cholesterol by 12.8mg/dL. Blood sugar control, as measured by hemoglobin A1c, improved most in patients with diabetes (−0.3 per cent), compared with those without (−0.1 per cent). Health care expenditures, except for the cost of semaglutide itself, rose by $80 each month, in part due to increased inpatient care for circulatory and metabolic diagnoses.
Clinicians should be aware that while semaglutide delivers measurable clinical benefits in reducing cardiovascular risk, it may also drive up health care expenses, possibly due to shifts in the patterns of service use or the management of more complex conditions. Long-term, robust cost-effectiveness analyses will be important to guide optimal prescribing and health policy, ensuring the greatest value for both patients and health systems. Future studies could consider including the costs of semaglutide and assessing whether initial increases in expenditure are offset by reductions in major cardiovascular events or complications over a longer period.
Reference
Lu Y et al. Changes in cardiovascular risk factors and health care expenditures among patients prescribed semaglutide. JAMA Netw Open. 2025;8(8):e2526013.
