Tirzepatide Demonstrates Improved Clinical Benefit and Lower Costs than Semaglutide in Adults With Obesity

Key Takeaways:

• Both semaglutide and tirzepatide are approved by the US Food and Drug Administration (FDA) to treat adults with obesity. The SUMMIT-5 trial found that tirzepatide was more effective than semaglutide and resulted in better clinical outcomes.
• A simulation model evaluating the cost-effectiveness of tirzepatide and semaglutide showed that tirzepatide resulted in cost savings of $41 688 per person and 0.506 quality of life years (QALYs) gained.
• Tirzepatide was associated with lower rates of obesity-related comorbidities and absenteeism than semaglutide, demonstrating improvements in both overall health and productivity.

Obesity is a growing concern in the US; data from 2023 indicated that 42% of US adults had obesity and 32% were overweight. Patients with obesity are also at risk of developing other health conditions such as type 2 diabetes (T2D), obstructive sleep apnea (OSA), and cardiovascular disease (CVD).

Medical costs associated with overweight and obesity are substantial as well. In 2021, obesity-related expenses averaged $2505 per person. Costs related to obesity and overweight are expected to amount to $4.1 trillion between 2024 and 2033.

Comparing Treatments for Obesity

Semaglutide and tirzepatide are incretin-based medications that have been approved by the FDA to be used in combination with diet and exercise to treat overweight and obesity in adults. The SUMMIT-5 clinical trial compared the efficacy of semaglutide and tirzepatide and found that tirzepatide was more effective in weight reduction.

Using data from the SUMMIT-5 trial, researchers conducted simulation modeling to analyze the cost-effectiveness of both medications in patients with a body mass index (BMI) ≥ 30 kg/m2 or ≥27 to <30 kg/m2 with 1 or more obesity-related complications.

Tirzepatide vs Semaglutide

The study found that tirzepatide resulted in less spending than semaglutide. Tirzepatide saved a total of $41 688 per person and had 0.506 QALYs gained, resulting in an incremental net health benefit (iNHB) of 0.784.

Additionally, tirzepatide demonstrated lower rates of obesity-related complications and comorbidities. The model demonstrated that per 1000 patients, there were 70 fewer cases of T2D and 10 fewer cases of CVD than with semaglutide. Patients receiving semaglutide were predicted to spend 3.07 more years with moderate to severe OSA than patients using tirzepatide.

Tirzepatide had a better impact on productivity than semaglutide. Patients receiving tirzepatide demonstrated 5 less days lost to absenteeism and presenteeism than patients using semaglutide.

Implications for Managed Care

The study supports the findings from SUMMIT-5 by demonstrating the higher efficacy of tirzepatide compared to semaglutide. Its clinical benefits extend beyond weight loss to include improvements in disease-related complications and productivity. Furthermore, the model also showed tirzepatide to be a lower-cost alternative to semaglutide.

The researchers said, “Collectively, these results support the value of tirzepatide as a clinically and economically advantageous treatment choice for patients and payers alike.”

Reference

Johansson E, Wilding JPH, Upadhyay N, et al. Cost-effectiveness of tirzepatide versus semaglutide for patients with obesity or overweight in the US: evidence from the SURMOUNT-5 head-to-head phase-3 trial. J Med Econ. 2026;9(1):1258–1278. doi:10.1080/13696998.2026.2646078