The Cost-Effectiveness of Semaglutide and Tirzepatide for Patients With Knee Osteoarthritis and Obesity.
Betensky. Daniel J DJ; Smith. Karen C KC; Katz. Jeffrey N JN; Yang. Catherine C; Hunter. David J DJ; Collins. Jamie E JE; Feldman. Candace H CH; Messier. Stephen P SP; Kim. Jason S JS; Selzer. Faith F; Paltiel. A David AD; Losina. Elena E
Key Findings
- Tirzepide provides greater health benefits at lower overall costs than semaglutide for obese patients with knee osteoarthritis.
- Its cost per quality‑adjusted life‑year (QALY) is about $57,400, which is considered cost‑effective compared with diet and exercise alone.
- While bariatric surgery (RYGB) remains the most cost‑effective option, tirzepide offers a strong non‑surgical alternative, especially when drug price and baseline BMI are favorable.
Practical Outcomes
- For biohackers and self‑directed health optimizers, tirzepide can be a worthwhile pharmacologic tool for weight loss and knee‑pain relief, often cheaper than surgery. Consider it as a first‑line option if the price is reasonable and your BMI is high, and use it before opting for invasive procedures.
Summary
Tirzepide, a weight‑loss drug, not only helps people drop pounds but also eases knee‑joint pain in those who are obese and have osteoarthritis. The study shows it gives more health benefit for less money than the similar drug semaglutide and is cheaper than surgery, making it a practical, cost‑effective option for everyday use.
Abstract
Glucagon-like peptide-1 receptor agonists (GLP1RAs) lead to substantial weight loss and pain reduction in persons with knee osteoarthritis and obesity. To evaluate the cost-effectiveness of 2 GLP1RAs, semaglutide and tirzepatide, for patients with osteoarthritis and obesity. Osteoarthritis Policy Model, a validated microsimulation model of knee osteoarthritis, to estimate lifetime benefits and costs of weight loss strategies. Published data to derive treatment-related weight loss, pain reduction, and costs of GLP1RAs from the U.S. Office of Health Policy. Persons with knee osteoarthritis and obesity in the United States. The base-case cohort had a Western Ontario and McMaster Universities Osteoarthritis Index pain score of 71 (0 to 100, 100 worst) and a mean body mass index (BMI) of 40 kg/m<sup>2</sup>. Lifetime. Health care, societal. Semaglutide, tirzepatide, laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and diet and exercise. Quality-adjusted life-years (QALYs), cost, and incremental cost-effectiveness ratios (ICERs). Tirzepatide provided greater health benefits at lower costs than semaglutide and yielded a $57 400 per QALY ICER versus diet and exercise. For those eligible, RYGB provided greater health benefits at lower costs than the 2 GLP1RAs and had a $30 700 per QALY ICER versus LSG. Tirzepatide's ICER was most sensitive to changes in medication costs, treatment efficacy, and cohort baseline BMI. Tirzepatide had a 64% and semaglutide had a 34% probability of being cost-effective at a $100 000 per QALY threshold. Data from multiple sources. Both tirzepatide and semaglutide would be widely considered cost-effective when compared directly with usual care. Tirzepatide would offer the most favorable return on investment to decision makers whose cost-effectiveness thresholds exceed $57 400 per QALY. The Arthritis Foundation and National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Study Information
pubmed
2025
2025-09-16T00:00:00.000Z
10.7326/annals-24-03609