extract: 2025-01-01-select-cost-effectiveness-analysis-obesity-cvd
Pentagon-Agent: Ganymede <F99EBFA6-547B-4096-BEEA-1D59C3E4028A>
This commit is contained in:
Teleo Agents
parent
4576cbbe76
commit
0203409b87
5 changed files with 62 additions and 1 deletions
|
|
@ -35,6 +35,12 @@ The Cell Press review characterizes GLP-1s as marking a 'system-level redefiniti
|
|||
|
||||
MA plans' near-universal prior authorization creates administrative friction that may worsen the already-poor adherence rates for GLP-1s. PA requirements ensure only T2D-diagnosed patients can access, effectively blocking obesity-only coverage despite FDA approval. This access restriction compounds the chronic-use economics challenge by adding administrative barriers on top of existing adherence problems.
|
||||
|
||||
|
||||
### Additional Evidence (challenge)
|
||||
*Source: [[2025-01-01-select-cost-effectiveness-analysis-obesity-cvd]] | Added: 2026-03-16*
|
||||
|
||||
SELECT trial cost-effectiveness analysis shows semaglutide achieves $32,219/QALY at 48% rebated prices (highly cost-effective) versus $136,271/QALY at list price (marginally cost-effective). Medicare deal at $245/month represents 82% price reduction. The inflationary impact claim may need scope qualification: GLP-1s are inflationary at list prices but potentially cost-saving at negotiated net prices, and recent price trajectory suggests faster-than-expected flip to cost-effectiveness.
|
||||
|
||||
---
|
||||
|
||||
Relevant Notes:
|
||||
|
|
|
|||
|
|
@ -30,6 +30,12 @@ For value-based care models and capitated payers, this multi-organ protection cr
|
|||
- Nature Medicine: additive benefits with SGLT2 inhibitors
|
||||
- First GLP-1 to receive FDA indication for CKD in T2D patients
|
||||
|
||||
|
||||
### Additional Evidence (confirm)
|
||||
*Source: [[2025-01-01-select-cost-effectiveness-analysis-obesity-cvd]] | Added: 2026-03-16*
|
||||
|
||||
SELECT trial modeling shows multi-organ savings hierarchy: T2D prevention $14,431, CKD prevention $2,074, CV event prevention $1,512 per subject lifetime. The compounding value exists but is heavily weighted toward metabolic protection (diabetes + kidney = $16,505) versus cardiovascular ($1,512).
|
||||
|
||||
---
|
||||
|
||||
Relevant Notes:
|
||||
|
|
|
|||
|
|
@ -28,6 +28,12 @@ This is the first dedicated kidney outcomes trial with a GLP-1 receptor agonist,
|
|||
- FDA indication expansion to T2D patients with CKD (2024)
|
||||
- Dialysis cost benchmark: $90K+/year per patient
|
||||
|
||||
|
||||
### Additional Evidence (extend)
|
||||
*Source: [[2025-01-01-select-cost-effectiveness-analysis-obesity-cvd]] | Added: 2026-03-16*
|
||||
|
||||
SELECT trial economic modeling quantifies CKD prevention savings at $2,074 per subject lifetime, which is 1.4x the CV event savings ($1,512) but only 14% of the diabetes prevention savings ($14,431). The kidney protection value is real but secondary to metabolic disease prevention in the economic hierarchy.
|
||||
|
||||
---
|
||||
|
||||
Relevant Notes:
|
||||
|
|
|
|||
|
|
@ -0,0 +1,32 @@
|
|||
{
|
||||
"rejected_claims": [
|
||||
{
|
||||
"filename": "glp-1-cost-effectiveness-is-price-dependent-with-rebated-prices-achieving-32k-per-qaly-versus-136k-at-list-price.md",
|
||||
"issues": [
|
||||
"missing_attribution_extractor"
|
||||
]
|
||||
},
|
||||
{
|
||||
"filename": "glp-1-diabetes-prevention-savings-exceed-cardiovascular-savings-by-10x-making-metabolic-protection-the-primary-economic-lever.md",
|
||||
"issues": [
|
||||
"missing_attribution_extractor"
|
||||
]
|
||||
}
|
||||
],
|
||||
"validation_stats": {
|
||||
"total": 2,
|
||||
"kept": 0,
|
||||
"fixed": 2,
|
||||
"rejected": 2,
|
||||
"fixes_applied": [
|
||||
"glp-1-cost-effectiveness-is-price-dependent-with-rebated-prices-achieving-32k-per-qaly-versus-136k-at-list-price.md:set_created:2026-03-16",
|
||||
"glp-1-diabetes-prevention-savings-exceed-cardiovascular-savings-by-10x-making-metabolic-protection-the-primary-economic-lever.md:set_created:2026-03-16"
|
||||
],
|
||||
"rejections": [
|
||||
"glp-1-cost-effectiveness-is-price-dependent-with-rebated-prices-achieving-32k-per-qaly-versus-136k-at-list-price.md:missing_attribution_extractor",
|
||||
"glp-1-diabetes-prevention-savings-exceed-cardiovascular-savings-by-10x-making-metabolic-protection-the-primary-economic-lever.md:missing_attribution_extractor"
|
||||
]
|
||||
},
|
||||
"model": "anthropic/claude-sonnet-4.5",
|
||||
"date": "2026-03-16"
|
||||
}
|
||||
|
|
@ -7,9 +7,13 @@ date: 2025-01-01
|
|||
domain: health
|
||||
secondary_domains: [internet-finance]
|
||||
format: paper
|
||||
status: unprocessed
|
||||
status: enrichment
|
||||
priority: medium
|
||||
tags: [glp-1, semaglutide, cost-effectiveness, cardiovascular, SELECT-trial, QALY]
|
||||
processed_by: vida
|
||||
processed_date: 2026-03-16
|
||||
enrichments_applied: ["GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035.md", "semaglutide-reduces-kidney-disease-progression-24-percent-and-delays-dialysis-creating-largest-per-patient-cost-savings.md", "glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints.md"]
|
||||
extraction_model: "anthropic/claude-sonnet-4.5"
|
||||
---
|
||||
|
||||
## Content
|
||||
|
|
@ -43,3 +47,10 @@ Cost-effectiveness analysis of semaglutide 2.4mg based on SELECT trial data, mod
|
|||
PRIMARY CONNECTION: [[GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035]]
|
||||
WHY ARCHIVED: Cost-effectiveness is price-dependent — the declining price trajectory may flip GLP-1s from inflationary to cost-effective faster than the existing claim anticipates
|
||||
EXTRACTION HINT: Focus on the price sensitivity of the cost-effectiveness conclusion and how recent price deals change the math
|
||||
|
||||
|
||||
## Key Facts
|
||||
- SELECT trial per 100,000 subjects (lifetime): 2,791 non-fatal MIs avoided, 3,000 revascularizations avoided, 487 strokes avoided, 115 CV deaths avoided
|
||||
- Average per-subject lifetime treatment cost: $47,353
|
||||
- Australian analysis: at A$4,175/year, ICER = A$96,055/QALY (~US$138K/QALY), not cost-effective at A$50K threshold
|
||||
- ICER 2025: semaglutide would need 80% price reduction to meet standard threshold at list price
|
||||
|
|
|
|||
Loading…
Reference in a new issue