Switching From Liraglutide to Semaglutide Improved Blood Sugar, Weight, and Saved Over $400,000 at a VA Hospital

Retrospective chart review of veterans without retinopathy treated at the Michael E. DeBakey VA Medical Center between March and November 2021. Patients on liraglutide 0.6 or 1.2 mg daily were converted to semaglutide 0.25 mg weekly (titrated to 0.5 mg after 4 weeks). HbA1c values were compared at baseline and 3–12 months post-conversion. Cost savings were calculated using outpatient pharmacy data.

With GLP-1 drugs being expensive, finding ways to optimize both clinical outcomes and costs is important for healthcare systems. This study shows that switching from an older daily GLP-1 peptide to a newer weekly one can improve blood sugar control, promote weight loss, and generate significant cost savings — a win across the board.

As healthcare systems manage the growing costs of GLP-1 medications, studies like this provide evidence-based guidance for formulary decisions and drug switching protocols. The VA system, which serves millions of veterans, demonstrated that therapeutic conversions between GLP-1 peptides can be done safely while improving outcomes and reducing costs.

This was a retrospective study without a control group, making it impossible to determine whether improvements were due to the drug switch or other factors. The conversion used relatively low semaglutide doses (0.5 mg), not the maximum approved dose (2.0 mg for diabetes, 2.4 mg for weight loss). The VA patient population (predominantly male veterans) may not be representative of the general population. A full cost-effectiveness analysis was not conducted.