Page 35 - GHES-3-3

Global Health Economics and
Sustainability
Semaglutide for treating T2D and obesity

preferences, especially when newer treatments come with use of GLP-1RA. Expanding health coverage is essential in
an increased risk of adverse effects. Although glycemic overcoming these challenges.
control and weight management are key treatment goals,
individuals with T2D may prioritize other factors, such 9.1. More policy-based solutions to address
as drug convenience and tolerability. In the United States, socioeconomic disparities in access to newer
fewer than 10% of individuals eligible for SGLT-2i therapy therapies
are prescribed these drugs, highlighting the need to For T2D patients in low- and middle-income countries,
address barriers to their use. Reducing adverse events and access to newer antidiabetic drugs could reduce the
further emphasizing the cardiovascular benefits of newer incidence of diabetes-related complications (Global
T2D therapies may help improve uptake and ensure that Health, 2021). Specific policy-based solutions are
more patients can benefit from these treatments (Savarese proposed to address socioeconomic disparities in
et al., 2023). access to newer therapies, focusing on reducing social
Joint physician-patient decision-making is also stratification and differential exposure to risk and
recommended in the management of T2D care (Tamhane vulnerability factors. These solutions include addressing
et al., 2015). Countries with national healthcare systems the unequal effects of disease in socioeconomic and health
characterized by universal reimbursement often provide terms through cross-sectoral actions and empowerment
better access to incretin-based therapies for a larger interventions. Proposed interventions include health
portion of the population, regardless of their economic system reconstruction (harmonized with principles of
status. However, access to GLP-1RA varies by country; availability and accessibility), medical staff redistribution,
for example, in the United Kingdom, they are only and the reinforcement of family doctor institutions.
prescribed to patients with T2D and obesity. In contrast, The goal is to maximize social benefits, reduce costly
in countries with predominantly private healthcare hospital admissions by separating primary, secondary, and
systems, individuals from lower socioeconomic tertiary care, and ensure total population health coverage,
backgrounds face significant access barriers due to the independent of employment status. Further measures
higher costs and limited insurance coverage. In the include controlling medicine consumption and cost
United States, despite support for low-income patients containment for economically vulnerable populations,
through Medicare, beneficiaries are less likely to receive encouraging citizen participation in co-decision
expensive medications like GLP-1RA compared to those regarding resource allocation, monitoring family budgets,
with private insurance. Similarly, in Germany, private and institutionalizing a minimum standard of living.
health insurance status plays a critical role in determining Expanding tax exemptions, allowances, and subsidies,
the likelihood of receiving GLP-1RA prescriptions. People along with the implementation of modern social protection
with T2D living in socio-economically disadvantaged programs, is also recommended, with an emphasis on
areas face additional difficulties related to the high cost improving income distribution. Income transfers targeting
of GLP-1RA, which leads many to choose less expensive vulnerable groups (through a fiscal mechanism promoting
therapeutic options that do not require subcutaneous social equality, distributive efficiency, and social justice)
injections. By prioritizing the implementation of the would help combat poverty and address social exclusion
cost-effective strategies, the healthcare systems can (Mentis, 2022). Other suggested actions include measuring
promote the expanded use of the beneficial incretin-based catastrophic health costs, reducing health inequalities,
therapies, maximizing the treatment benefits in T2DM upgrading financial risk protection, and promoting the use
people (McCoy et al., 2021) with the cost of the GLP1-RAs of generics with reliable production processes and lower
needed to be reduced by at least 70 % to be considered as distribution costs. These efforts should be carried out under
cost-effective measured by Incremental Cost Effectiveness the oversight of international competition authorities to
Ratio (ICER) (Choi et al., 2022). Futhermore, body weight counter anti-competitive corporate practices and ensure
loss treatments may not be suitable for elderly patients, non-discriminatory access to medicines, with a focus on
and the subcutaneous administration of most GLP- harmonizing business practices with existing legislation
1RA makes them less feasible for visually or cognitively and defending health as a public good (Mentis, 2021).
impaired individuals. Addressing these access barriers is
crucial for improving the use of GLP-1RA, particularly by 9.2. Perspectives for Clinical Practice
implementing measures that improve access to healthcare To further strengthen the clinical robustness of results,
services for people with T2D in low-income areas. These randomized prospective studies are recommended,
areas often suffer from a shortage of diabetes specialists involving overweight, uncontrolled T2D patients treated
and insufficient training for primary care physicians in the with semaglutide in addition to their existing treatment,

Volume 3 Issue 3 (2025) 27 https://doi.org/10.36922/ghes.8547