OBJECTIVES: This study analyzed the impact of two anti-obesity medications (AOMs) on cardiovascular disease (CVD) incidence, healthcare resource utilization (HCRU), and costs among US patients with obesity, a major driver of healthcare expenditures.

METHODS: Utilizing Kythera data, a retrospective cohort study was conducted from November 2022 to June 2024. Patients with obesity and AOM use were identified based on diagnosis claims and prescription claim(s) for Zepbound or Wegovy (identification period: 11/1/2023-12/31/2023), with 6 months of follow-up to measure CVD incidence, HCRU, and cost. Patients with pre-existing CVD and prior AOM use were excluded. Multivariable analyses adjusted for comorbidities and sociodemographic factors were employed to assess the incidence of cardiovascular events, HCRU, and cost with additional analyses comparing outcomes between Zepbound and Wegovy users.

RESULTS: We identified 22,620 patients with obesity using AOMs (Wegovy users=19,801 patients, Zepbound users=2,819 patients) and 84,427 patients without AOM use. AOM users demonstrated significantly lower incidence of cardiovascular events (1.77%) than non-AOM users (12.17%, p<0.0001). The AOM cohort had lower hospital admission rates (1.63% vs 6.62%, p<0.0001), shorter length of stay (0.12 vs 1.27 days, p<0.0001), and lower emergency department (ED) visit (6.23% vs 13.06%, p<0.0001) and outpatient visit rates (80% vs 82%, p<0.0001) than the non-AOM cohort. The AOM cohort incurred lower total health expenditures ($8,055.65 vs $9,722.92; (p<0.0001). Zepbound users had a lower incidence of cardiovascular events (1.14% vs 1.86%, p=0.0064), shorter length of stay (0.07 vs 0.12 days, p=0.0225), lower ED visit (3.33% vs 6.65%, p<0.0001), and outpatient visit rates (77.19% vs 80.39%, p<0.0001), and lower total healthcare expenditures ($7,184.25 vs $8,179.71, p<0.0001) than Wegovy users.

CONCLUSIONS: AOM use was associated with a significantly lower incidence of cardiovascular events, lower HCRU, and lower total health expenditures, than non-AOM use, highlighting these medications as promising interventions in obesity management and decreasing the economic burden of CVD.