domains/health/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

@@ -29,6 +29,12 @@ Real-world persistence data from 125,474 commercially insured patients shows the
 
 The Cell Press review characterizes GLP-1s as marking a 'system-level redefinition' of cardiometabolic management with 'ripple effects across healthcare costs, insurance models, food systems, long-term population health.' Obesity costs the US $400B+ annually, providing context for the scale of potential cost impact. The WHO issued conditional recommendations within 2 years of widespread adoption (December 2025), unusually fast for a major therapeutic category.
 
+
+### Additional Evidence (extend)
+*Source: [[2025-01-01-select-cost-effectiveness-analysis-obesity-cvd]] | Added: 2026-03-15*
+
+SELECT trial modeling shows semaglutide is highly cost-effective at net prices ($32K/QALY with 48% rebate) but borderline at list prices ($136K/QALY). Recent Medicare deals at $245/month versus $1,350/month list price fundamentally change the cost-effectiveness calculation. The declining price trajectory may flip GLP-1s from inflationary to cost-effective faster than 2035 projection.
+
 ---
 
 Relevant Notes:

domains/health/glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints.md

@@ -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: 2026-03-15*
+
+Lifetime modeling quantifies multi-organ savings: $14,431 per subject from avoided T2D, $2,074 from avoided CKD, $1,512 from avoided CV events. Diabetes prevention alone generates 9.6x the economic value of cardiovascular protection, confirming that multi-organ effects compound economic value beyond any single endpoint.
+
 ---
 
 Relevant Notes:

inbox/archive/.extraction-debug/2025-01-01-select-cost-effectiveness-analysis-obesity-cvd.json

@@ -0,0 +1,32 @@
+{
+  "rejected_claims": [
+    {
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+        "missing_attribution_extractor"
+      ]
+    },
+    {
+      "filename": "semaglutide-diabetes-prevention-savings-exceed-cardiovascular-savings-by-10x-with-14431-per-subject-from-avoided-t2d-versus-1512-from-cv-events.md",
+      "issues": [
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+  ],
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+}

inbox/archive/2025-01-01-select-cost-effectiveness-analysis-obesity-cvd.md

@@ -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: 2026-03-15
+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", "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 +47,12 @@ 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 cost-effectiveness analysis modeled lifetime outcomes for obese/overweight patients with established CVD but without diabetes
+- Per 100,000 subjects treated (lifetime horizon): 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 yields ICER of A$96,055/QALY (~US$138K/QALY)
+- ICER 2025 assessment: semaglutide and tirzepatide now meet <$100K/QALY at net prices (shift from 2022)
+- Study was industry-funded by Novo Nordisk with 48% rebate as their assumption of actual net pricing