Michigan Model Finds Semaglutide and Sleeve Gastrectomy Both Cost-Effective for Older Adults With Obesity and Heart Disease, With Surgery Slightly Ahead
A University of Michigan simulation published October 7, 2026 in Obesity modeled Black and White adults aged 65 to 70 with a BMI of 35 or higher and cardiovascular disease over 25 years. Compared with no treatment, semaglutide 2.4 mg cost $7,300 and sleeve gastrectomy $12,100 per quality-adjusted life year gained, and surgery cost $53,700 per extra quality-adjusted year compared with semaglutide, within the model's $100,000 threshold. Surgery was the most cost-effective option in 57% of simulations; semaglutide was slightly more equitable between the two groups but not enough to change the ranking.