In a noteworthy session last week at the American Heart Association conference, researchers presented evidence that the obesity drug semaglutide (Wegovy), a glucagon-like peptide-1 receptor agonist, demonstrated benefits beyond weight loss by reducing the overall rate of major cardiovascular concerns by 20%. In the results of double-blind trial, which appear in the New England Journal of Medicine, they found a reduced incidence of heart attacks, cardiovascular-related deaths, and strokes. Semaglutide notably reduced heart attacks by 28%, cardiovascular-related deaths by 15%, and strokes by 7%, particularly in patients already taking statins. Over 5 years, more than 17,600 participants who had existing obesity and heart disease but did not have diabetes, received weekly doses of 2.4 mg of subcutaneous semaglutide. This marks the first rigorous trial evidence that demonstrates an obesity drug like Wegovy can also improve cardiovascular outcomes. Researchers will need to further investigate whether the cardiovascular benefits were from the drug itself or were a byproduct of the study participants’ weight loss.  However, the difference between patients who received semaglutide and those who were given a placebo began to appear almost immediately after starting treatment, researchers said.
Pharmacoeconomics will be an issue: Even with this news about the beneficial cardiovascular outcomes, the question of access to semaglutide will no doubt come into play. With a $16,000 annual price tag for semaglutide and its potential applicability for the more than 41% of Americans who are considered obese, the systemwide cost of this new generation of weight loss drugs could be especially steep. Insurers—generally reluctant to offer coverage for these types of drugs because of cost—might take a second look when considering the cardiovascular benefits.