Evidence map›Paper›PMID 40953447›Full record

ArticleAnnals of internal medicine2025

The Cost-Effectiveness of Semaglutide and Tirzepatide for Patients With Knee Osteoarthritis and Obesity.

Daniel J Betensky, Karen C Smith, Jeffrey N Katz, Catherine Yang, David J Hunter, Jamie E Collins, Candace H Feldman, Stephen P Messier, Jason S Kim, Faith Selzer and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Daniel J BetenskyPolicy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center and Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts (D.J.B., C.Y.).
Karen C SmithPolicy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center and Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts (K.C.S., J.E.C., F.S.).ORCID 0000-0003-0330-1610
Jeffrey N KatzPolicy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center and Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital; Harvard Medical School; Section of Clinical Sciences, Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital; and Departments of Epidemiology and Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts (J.N.K.).ORCID 0000-0003-2104-4670
Catherine YangPolicy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center and Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts (D.J.B., C.Y.).
David J HunterRheumatology Department, Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia (D.J.H.).ORCID 0000-0003-3197-752X
Jamie E CollinsPolicy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center and Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts (K.C.S., J.E.C., F.S.).ORCID 0000-0001-8413-007X
Candace H FeldmanHarvard Medical School and Section of Clinical Sciences, Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Massachusetts (C.H.F.).ORCID 0000-0002-4980-9770
Stephen P MessierJ.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina (S.P.M.).
Jason S KimArthritis Foundation, Atlanta, Georgia (J.S.K.).ORCID 0000-0001-5089-8048
Faith SelzerPolicy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center and Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts (K.C.S., J.E.C., F.S.).
A David PaltielPublic Health Modeling Unit, Yale School of Public Health, New Haven, Connecticut (A.D.P.).ORCID 0000-0002-4861-3290
Elena LosinaPolicy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center and Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopaedic Surgery, Brigham and Women's Hospital; Harvard Medical School; and Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts (E.L.).ORCID 0000-0002-3424-0892

Funding

VERITY: Value and Evidence in Rheumatology using bioInformaTics, and advanced analYticsP30AR072577 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI Daniel Hal Solomon · 2017 to 2026
$9.8M
Optimizing the value of pain management in knee OA patients with comorbiditiesR01AR074290 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI Elena Losina · 2018 to 2026
$5.9M
NIAMS NIH HHS P30 AR072577NIAMS NIH HHS R01 AR074290
6 · The paper itself

Abstract

backgroundGlucagon-like peptide-1 receptor agonists (GLP1RAs) lead to substantial weight loss and pain reduction in persons with knee osteoarthritis and obesity.

objectiveTo evaluate the cost-effectiveness of 2 GLP1RAs, semaglutide and tirzepatide, for patients with osteoarthritis and obesity.

designOsteoarthritis Policy Model, a validated microsimulation model of knee osteoarthritis, to estimate lifetime benefits and costs of weight loss strategies. DATA SOURCES: Published data to derive treatment-related weight loss, pain reduction, and costs of GLP1RAs from the U.S. Office of Health Policy. TARGET POPULATION: 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 TIME HORIZON: Lifetime. PERSPECTIVE: Health care, societal.

interventionSemaglutide, tirzepatide, laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and diet and exercise. OUTCOME MEASURES: Quality-adjusted life-years (QALYs), cost, and incremental cost-effectiveness ratios (ICERs). RESULTS OF BASE-CASE ANALYSIS: 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. RESULTS OF SENSITIVITY ANALYSIS: 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. LIMITATION: Data from multiple sources.

conclusionBoth 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. PRIMARY FUNDING SOURCE: The Arthritis Foundation and National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Indexed as

Glucagon-Like Peptide-1 Receptor AgonistsGlucagon-Like PeptidesObesityOsteoarthritis, KneeCost-Benefit AnalysisFemaleGlucagon-Like Peptide 1HumansMaleMiddle AgedQuality-Adjusted Life YearsSemaglutideTirzepatideWeight LossGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsGlucagon-Like PeptidesSemaglutideTirzepatide

Identifiers

PMID40953447
PMCPMC13229537

What Socratic holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.