Real-world study finds tirzepatide associated with lower healthcare costs in adults over 55 with obesity

A real-world study has examined healthcare costs and resource use among US adults aged over 55 receiving tirzepatide for weight management, compared with matched untreated individuals.

The Baseline

• A real-world study compared healthcare costs and resource use among persistent tirzepatide users and matched untreated adults aged over 55.
• Healthcare costs excluding tirzepatide were lower among users, with estimated differences increasing over longer follow-up.
• The authors considered whether these healthcare cost differences could offset treatment costs in the context of the Medicare GLP-1 Bridge program.

Eli Lilly has announced findings from a real-world study examining healthcare costs and resource use among adults aged over 55 receiving tirzepatide for weight management. Published in Diabetes, Obesity and Metabolism, the study compared persistent tirzepatide users with matched untreated individuals and considered the findings in the context of the Medicare GLP-1 Bridge program.

The retrospective matched-cohort study used de-identified claims data from the Komodo Research Dataset and included adults with obesity, or overweight with at least one weight-related comorbidity, who did not have diabetes. The analysis included 15,843 tirzepatide users and 15,843 matched controls, with a mean age of approximately 65 years. Participants were matched on demographic and clinical characteristics, obesity-related complications and previous healthcare utilization.

In the primary analysis, which used inverse probability of censoring weighting to account for differences in follow-up and potential informative censoring, all-cause healthcare costs excluding the cost of tirzepatide were $145 lower per person per month in the tirzepatide cohort than in the control group during months 6–12, a relative difference of 12.3%. During months 12–18, the estimated difference was $319 per person per month, or 25.4%.

A supporting analysis using pairwise censoring estimated differences of $181 per person per month during months 6–12 and $607 during months 12–18, also excluding tirzepatide costs. The study reported that non-tirzepatide healthcare costs remained broadly stable in the tirzepatide cohort while increasing in the control group over the follow-up period.

Differences were also observed in healthcare resource use. In the primary analysis, the relative change in inpatient admissions and emergency department visits from baseline was lower in the tirzepatide cohort than in controls across all follow-up periods. The incidence rate ratio was 0.76 during months 6–12 and 0.69 during months 12–18. No significant differences were observed in changes in outpatient or office visit rates between the groups.

The authors also considered the findings in the context of the Medicare GLP-1 Bridge program, under which they reported a net monthly cost to Medicare of $195 for tirzepatide. The temporary program has been extended until the end of 2027 while the Medicare Part D component of the BALANCE Model remains delayed pending further evaluation and data collection. The study excluded tirzepatide costs from its healthcare cost outcomes because net prices and manufacturer rebates were not captured in the claims data. The reported differences therefore reflect healthcare costs excluding tirzepatide rather than the overall net cost of treatment.

Based on the observed differences in other healthcare costs, the authors suggested that these differences could partially offset the cost of tirzepatide by 12 months and potentially result in savings by 18 months among individuals who remained on treatment. Discussing the potential implications for Medicare, they stated:

“These findings indicate that coverage for tirzepatide for weight management may have economic benefits for Medicare in the near term.”

The authors also considered the potential for longer-term savings, citing estimates that weight management medications could save Medicare between “$175 to $245 billion in the first 10 years of coverage increasing to up to $846 billion after 30 years.” These longer-term estimates were not generated by the current study, which followed participants for up to 18 months.

The authors identified limitations including potential residual confounding and reduced follow-up at later time points. Fewer than 10% of participants remained uncensored during months 12–18, limiting the precision and generalizability of estimates for this period. Because follow-up was censored when treatment was discontinued, the findings apply to individuals who remained on tirzepatide and do not establish cost outcomes following discontinuation.