Semaglutide 2.4 mg is cost-effective versus liraglutide 3 mg for obesity in Greece, with an ICER of €12,724 per QALY gained and dominating liraglutide (better outcomes at lower cost) in 80.8% of probabilistic simulations.
80.8% dominanceSemaglutide provided better health outcomes at lower cost than liraglutide in over 4 out of 5 economic scenarios modeled
What the researchers found
Semaglutide 2.4 mg yielded an ICER of €12,724 per QALY gained versus liraglutide 3 mg. In probabilistic sensitivity analysis, semaglutide dominated liraglutide (higher QALYs at lower cost) in 80.8% of simulations and reached 100% cost-effectiveness probability at a €9,000/QALY threshold.
Why it matters
Cost-effectiveness data directly influences which peptide drugs get government reimbursement and therefore patient access. This analysis supports expanding access to semaglutide for obesity treatment in Greece, where currently only liraglutide is reimbursed.
The numbers in context
Modeled BMI >= 35 kg/m2 with >= 1 comorbidity. 40-year time horizon. 3.5% annual discount rate. Costs in 2025 euros. Outcomes in LYs and QALYs. Based on STEP-8 trial data.
How the study worked
State-transition economic model with 40-year time horizon, using STEP-8 trial efficacy data, Greek cost inputs (2025 euros), 3.5% annual discount rate, with deterministic, scenario, and probabilistic sensitivity analyses from the Greek third-party payer perspective.
Who was studied
Adults with morbid obesity (BMI >= 35) and weight-related comorbidities in Greece
What this study cannot tell us
Based on a single clinical trial (STEP-8) for efficacy inputs. Long-term outcomes projected from models, not observed data. Specific to Greek cost structure and healthcare system. Limited to patients with BMI ≥35 and weight-related comorbidities.
How to read the evidence
Health economic model based on randomized trial data (STEP-8). Strong methodology with comprehensive sensitivity analyses, but conclusions are model-dependent and specific to the Greek healthcare context.
When this study was published
Published in 2025 with cost inputs in 2025 euros; reflects current drug pricing and healthcare economics.
The bigger picture
As GLP-1 peptide drugs become standard obesity treatments worldwide, cost-effectiveness analyses like this determine which patients get access through public health systems. The finding that semaglutide dominates liraglutide in most scenarios may influence reimbursement decisions beyond Greece.
Questions still open
- Would semaglutide remain cost-effective in broader obesity populations (BMI 30-35)?
- How would the cost-effectiveness change if oral semaglutide or tirzepatide were included as comparators?
- Will real-world adherence patterns change the cost-effectiveness ratio compared to trial-based estimates?
Common questions
What does cost-effective mean for obesity drugs?
Why is semaglutide compared specifically to liraglutide?
Read the original research
Cost-effectiveness of semaglutide 2.4 mg versus liraglutide 3 mg for the treatment of obesity in Greece.
Frontiers in public health, 13, 1690211
Citation
Papantoniou, Panagiotis; Maniadakis, Nikolaos. (2025). Cost-effectiveness of semaglutide 2.4 mg versus liraglutide 3 mg for the treatment of obesity in Greece.. Frontiers in public health, 13, 1690211. https://doi.org/10.3389/fpubh.2025.1690211