Analysis finds Wegovy needs a price cut to justify widespread cardiac use

Semaglutide, the active ingredient in the anti-obesity drug Wegovy, offers cardiovascular benefits for patients without diabetes who have established heart disease, but price reductions would be needed for it to be considered cost-effective, according to a new analysis published in JAMA Cardiology.

Wegovy is approved both as an oral and as an injection for weight loss and to reduce the risk of major adverse cardiovascular events in adults who are obese or overweight. The injection form of Wegovy is also approved to treat metabolic dysfunction-associated steatohepatitis (MASH).

Researchers wanted to determine whether semaglutide would be cost-effective when used as secondary prevention of cardiovascular disease and what the potential effect would be on U.S. healthcare spending.

They found that lifetime treatment with semaglutide would avoid more than 358,000 heart attacks, strokes, and cardiovascular deaths. Preventing those events is estimated to save nearly $15 billion in healthcare spending for cardiovascular care and $8 billion in spending for other care. But the drug itself would cost $344 billion over those same lifetimes, meaning the healthcare savings would offset only a fraction of the increased pharmaceutical spending.

“To our knowledge, this is the first study to systematically examine the value of lifelong semaglutide for preventing heart attacks and strokes in United States adults with established cardiovascular disease,” senior author Dhruv S. Kazi, M.D., MSc, MS, associate director of the Richard A. and Susan F. Smith Center for Outcomes Research and medical director of the Cardiac Critical Care Unit at Beth Israel Deaconess Medical Center (BIDMC), said in a news release. “The health benefits are real, but we shouldn’t expect them to offset the cost of the drug — semaglutide saves lives, but it won’t save money.”

Researchers assessed data for U.S. adults age 45 years or older, with a body mass index of 27 or higher and a history of myocardial infarction or stroke and without diabetes between January 2024 and June 2025.

They study incorporated the findings of the SELECT trial into the Cardiovascular Disease Policy Model, a validated population-level simulation model of cardiovascular disease outcomes and costs in the United States, to evaluate lifetime cost-effectiveness when semaglutide was added to standard of care.

The model used an annual semaglutide cost of $8,604 (2023 U.S. price net after rebates and discounts, as well as the incremental cost for each quality-adjusted life-year, or QALY, gained. By using QALYs, economists account for both length and quality of life gained.

Researchers found that semaglutide costs $148,100 per QALY gained, exceeding the $120,000 threshold widely accepted as cost-effective. A price reduction from $8,604 to $7,055 annually would bring semaglutide within the cost-effective range, they said.

The research was supported by institutional funds from the Richard A. and Susan F. Smith Center for Outcomes Research and the University of California, San Francisco.

Wegovy and Novo Nordisk’s other semaglutide products — Ozempic and Rybelsus for diabetes — were part of the most recent drugs to be negotiated through the Inflation Reduction Act’s (IRA) Medicare price negotiation program for Part D. In November 2025, CMS announced that it negotiated a 71% discount off the list price, or $274 for a 30-day supply, on the semaglutide products.

The Wegovy pill is also available direct-to-consumer through TrumpRx for $149 a month for the 1.5 mg tablet and $199 for the 4 mg tablet for cash-paying patients. An Ozempic pill will be available in the second quarter of 2026, according to Novo Nordisk.