The True ROI of GLP-1s: Look Beyond Pharmacy Cost

When assessing the return on investment of any medical intervention, including GLP-1 medications, it is critical to evaluate the total cost of care, including both medical and pharmacy spend, compared with a matched cohort. Focusing only on pharmacy cost provides an incomplete and often misleading picture. The broader clinical impact must be considered, especially for populations with cardiometabolic disease. Emerging evidence shows that GLP-1 receptor agonists may provide meaningful downstream value. In patients with diabetes and a history of peripheral vascular events, GLP-1 therapies were associated with reduced risk of amputation, major adverse cardiovascular events, cardiovascular death, all-cause mortality, and progression to dialysis compared with other glucose-lowering medications (Hsiao et al., 2026). These outcomes represent significant clinical and financial implications, as preventing complications such as dialysis, amputations, and hospitalizations can substantially reduce long-term medical costs. Evaluating GLP-1 therapies through a total cost of care lens, rather than pharmacy cost alone, provides a more accurate assessment of their true value and return on investment.

Hsiao, F., Hsu, T., Hsieh, Y., et al. (2026). Glucagon-like peptide-1 receptor agonists and prior major adverse limb events in patients with diabetes. JAMA Network Open, 9(1), e2555952. https://doi.org/10.1001/jamanetworkopen.2025.55952