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Semaglutide 2.4 mg reduces the incidence of obesity-related complications and is cost-effective in Japan under retreatment scenarios.

In a lifetime economic model from a Japanese public payer perspective, semaglutide 2.4 mg plus diet and exercise reduced the incidence of obesity-related complications such as type 2 diabetes, cardiovascular events, obstructive sleep apnea, and gout compared to diet and exercise alone. The incremental cost-effectiveness ratio was ¥5,300,580/QALY for patients without type 2 diabetes and ¥7,077,984/QALY for those with type 2 diabetes, with retreatment improving QALY gains.

Last updated: Jul 8, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Cost-Effectiveness of Semaglutide 2.4 mg for Obesity Disease Management in Japan: A Lifetime Economic Modeling Study Incorporating Retreatment Scenarios.

observational

Kamada Y, Wada S, Matsuda H, Dai Y · Journal of health economics and outcomes research (2026)

Participants: N/A
Duration: lifetime
Intervention: Semaglutide 2.4 mg plus diet and exercise, with retreatment scenarios (0, 1, or 2 retreatments) and a fixed 1-year off-treatment period after each regimen.
Outcome: Incremental cost-effectiveness ratio (ICER) in Japanese yen per quality-adjusted life year (QALY), incidence of obesity-related complications (type 2 diabetes, cardiovascular events, obstructive sleep apnea, gout).
Effect Size: N/A (ICER reported: ¥5,300,580/QALY for patients without T2D; ¥7,077,984/QALY for patients with T2D)
Population: People with obesity disease in Japan meeting Optimal Use Promotion Guidelines criteria: BMI ≥35 kg/m² with at least 1 obesity-related comorbidity (hypertension, dyslipidemia, or type 2 diabetes), or BMI ≥27 kg/m² with at least 2 obesity-related health disorders.

Result:

PubMed: 42394652DOI: 10.36469/001c.162614

Mechanism Graph

Semaglutide 2.4 mg activates GLP-1 receptors, reducing appetite and promoting weight loss.
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Weight loss reduces risk factors such as hypertension, dyslipidemia, and insulin resistance.
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Reduced risk factors lower the incidence of obesity-related complications like type 2 diabetes and cardiovascular events.
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Result: Improved quality-adjusted life years and reduced healthcare costs over a lifetime.

Limitations

  • ⚠Uncertainty remains around retreatment efficacy and long-term discontinuation rates.
  • ⚠The model relies on assumptions from Japanese studies, which may have limited generalizability to other populations or settings.

Frequently Asked Questions

What is the cost-effectiveness threshold in Japan for semaglutide 2.4 mg?▼

The study reports ICERs of ¥5.3 million/QALY for patients without type 2 diabetes and ¥7.1 million/QALY for those with type 2 diabetes, which are generally considered cost-effective in Japan.

Does retreatment with semaglutide improve outcomes?▼

Yes, the study found that retreatment (up to 2 retreatments with a 1-year off-treatment period) significantly improved QALY gains compared to limited or no retreatment.

What are the eligibility criteria for semaglutide in Japan?▼

Patients must have a BMI ≥35 kg/m² with at least one obesity-related comorbidity, or a BMI ≥27 kg/m² with at least two obesity-related health disorders, as per the Optimal Use Promotion Guidelines.

How does semaglutide reduce obesity-related complications?▼

Semaglutide promotes weight loss, which in turn reduces risk factors like hypertension, dyslipidemia, and insulin resistance, leading to lower incidence of complications such as type 2 diabetes and cardiovascular events.

Products

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References

  1. 1.Kamada Y, Wada S, Matsuda H, Dai Y. "Cost-Effectiveness of Semaglutide 2.4 mg for Obesity Disease Management in Japan: A Lifetime Economic Modeling Study Incorporating Retreatment Scenarios.." Journal of health economics and outcomes research, 2026. PMID: 42394652 DOI: 10.36469/001c.162614
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.