Ann Intern Med

GLP-1s cost-effective for knee OA in patients with obesity

September 22, 2025

Study details: Using the Osteoarthritis Policy Model, a validated microsimulation model of knee osteoarthritis (OA), researchers evaluated lifetime cost-effectiveness of semaglutide, tirzepatide, bariatric surgery (laparoscopic sleeve gastrectomy [LSG], Roux-en-Y gastric bypass [RYGB]), and diet/exercise in U.S. adults with knee OA and obesity (mean BMI, 40 kg/m², baseline pain score, 71/100). Data sources included published literature and U.S. health policy cost estimates. Outcomes were assessed from both healthcare and societal perspectives.

Results: Tirzepatide yielded greater quality-adjusted life-years (QALYs) and lower costs than semaglutide, with an incremental cost-effectiveness ratio (ICER) of $57,400 per QALY vs. diet/exercise. RYGB was most cost-effective for eligible patients, outperforming GLP-1s with an ICER of $30,700 per QALY. Sensitivity analyses showed tirzepatide remained cost-effective in 64% of simulations at a $100,000/QALY threshold, compared with 34% for semaglutide.

Clinical impact: GLP-1 RAs, particularly tirzepatide, represent a cost-effective strategy for managing knee OA in patients with obesity, especially when surgery isn’t an option. These findings support broader use of GLP-1s in OA care and may guide payer and policy decisions around coverage and access.

Source:

Betensky DJ, et al. (2025, September 16). Ann Intern Med. The Cost-Effectiveness of Semaglutide and Tirzepatide for Patients With Knee Osteoarthritis and Obesity. https://pubmed.ncbi.nlm.nih.gov/40953447/