Don Tracy, Associate Editor 

 Zepbound delivers 17.8%–20.8% average weight loss, while injectable Wegovy achieves 14%–17%, and oral Wegovy 11.4%, highlighting effective obesity management options.

 All therapies are highly cost-effective at conventional thresholds, with QALY estimates of $53,400 for tirzepatide, $61,400 for injectable semaglutide, and $69,300 for oral semaglutide.

 Despite strong clinical benefits, fewer than 1% of eligible US adults are able to afford GLP-1 treatments at current net prices, emphasizing the need for broader coverage and policy solutions.

The Institute for Clinical and Economic Review (ICER) has released a Draft Evidence Report evaluating the comparative clinical effectiveness and value of Novo Nordisk’s Wegovy (semaglutide) and Eli Lilly’s Zepbound (tirzepatide) for obesity management, including their impact on other obesity-related outcomes. ICER stated that the preliminary draft represents the midpoint of its eight-month assessment process and should not be interpreted as the organization’s final conclusions.

How Effective and Cost-Efficient are the Newest Obesity Treatments?

The initial draft found that both agents, when added to lifestyle modification, produced significant weight loss, improvements in obesity-related comorbidities, and reductions in cardiovascular risk factors.

Zepbound demonstrated the greatest weight loss benefits, with average weight loss ranging from 17.8% to 20.8%, and a head-to-head trial showing 20.2% loss versus 13.7% with injectable Wegovy. Early topline results in diabetes populations also suggest promising cardiovascular benefits, including an 8% reduction in major adverse cardiovascular events and a 16% reduction in all-cause mortality.

Injectable Wegovy demonstrated sustained weight loss of 14% to 17% and provided clear cardiovascular benefit, lowering major adverse cardiovascular events by 20% and all-cause mortality by 19% in patients with established cardiovascular disease.

Oral Wegovy also proved effective, producing an 11.4% average reduction, though with somewhat less impact than the injectable form, raising questions about its long-term cardiovascular benefits.

Safety profiles were largely consistent across medications.

The most common adverse events (AEs) were gastrointestinal, including nausea, diarrhea, and constipation, affecting up to 75% of patients treated with Zepbound and 20%–40% of patients treated with Wegovy.

Overall discontinuation due to AEs was below 10%.

The analysis found all three medications to be highly cost-effective at conventional thresholds.

Incremental cost-effectiveness ratios were estimated at $53,400 per quality-adjusted life year gained for tirzepatide, $61,400 for injectable semaglutide, and $69,300 for oral semaglutide.

Despite favorable cost-effectiveness, ICER projected affordability concerns: at current net prices of $6,830 for semaglutide and $7,973 for tirzepatide, fewer than 1% of eligible adults in the United States could be treated before surpassing ICER’s budget impact threshold of $880 million annually.

In the United States, the current estimated prevalence of obesity is around 40%, with no significant differences found between men and women across all age groups.

“Despite the number of therapies available, there remain challenges to accessing highly effective obesity medications and thus additional options for treatment may be beneficial in closing the treatment gap,” explained the authors of the report.

The report concluded that both treatments provide meaningful clinical benefits, with Zepbound achieving the most significant weight loss and Wegovy demonstrating established cardiovascular protection. Both were determined to be highly cost-effective but pose serious affordability and access challenges if broadly adopted.

As part of its Early Insights Webinar Series, David Rind, CEO, ICER, is expected to present the initial findings on September 18, 2025, in a webinar available exclusively to ICER Analytics platform users. The final report will be discussed during a virtual public meeting of the New England Comparative Effectiveness Public Advisory Council on November 13, 2025, during which the independent council will vote on key questions from the report.

Institute for Clinical and Economic Review Releases Draft Evidence Report on Treatments for Obesity. 

September 10, 2025. Accessed September 10, 2025. 

https://icer.org/news-insights/press-releases/institute-for-clinical-and-economic-review-releases-draft-evidence-report-on-treatments-for-obesity/

Semaglutide and Tirzepatide for Obesity Effectiveness and Value. 

https://icer.org/wp-content/uploads/2025/09/ICER_Obesity_Draft-Report_For-Publication_090925.pdf

Obesity and Severe Obesity Prevalence in Adults: United States, August 2021–August 2023. 

https://www.cdc.gov/nchs/products/databriefs/db508.htm#:~:text=2021%E2%80%93August%202023-,1,59%2C%20and%2060%20and%20older

Articles

ICER's Draft Evidence Report evaluates the clinical effectiveness and value of Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound for obesity management. Both treatments, when combined with lifestyle modifications, show significant weight loss and improvements in obesity-related comorbidities. Zepbound offers greater weight loss benefits, while Wegovy provides notable cardiovascular protection. Despite being cost-effective, affordability and access remain challenges due to high prices. The report emphasizes the need for additional treatment options to address the obesity treatment gap, with final conclusions pending further stakeholder engagement and analysis.

The draft assessment finds that the popular weight loss drugs are costly but worth the price tag, while also urging for broader coverage and policy solutions.

ICER Releases Cost Analysis Report on Obesity Treatments Semaglutide, Tirzepatide

Pharma Regulatory Strategies Could Shift as Vaccine Support Declines

, Ron Lanton, partner at Lanton Law, discussed the high-stakes implications of a new lawsuit filed by leading medical organizations to restore access to COVID-19 vaccines for children and pregnant people. Lanton explained how the case reflects deeper tensions between scientific standards, federal authority, and political influence, while also outlining what pharmaceutical supply chain leaders should watch for in terms of compliance, risk, and operational impact.

PC: How could this create new precedent that reshapes pharma’s regulatory strategy, especially for vaccines and biologics?

It’s fairly simple. If vaccines aren’t trusted by the public or lack political support, funding and development will likely dry up. That’s the ultimate impact. But because we live in a capitalistic society, someone will always find a need somewhere.

Even if the U.S. steps back from being a leader in vaccines—which, based on current signals from HHS, seems possible—diseases won’t disappear. There will still be demand in regions like Asia, Africa, the EU, Canada, and Central and South America.

The question becomes: where does the United States fit in this landscape? I find it hard to believe that Americans as a whole don’t want vaccines. There will always be a segment of the population that values them. What we’re likely to see is a slow, gradual decrease in support, possibly concentrated in specific areas, like HIV, for example. Time will tell.

: The recent lawsuit filed by major medical organizations to restore broader access to COVID-19 vaccines for children and pregnant people underscores the growing tension between science, law, and politics in federal health policy. The case challenges actions taken under HHS leadership, particularly those linked to Robert F. Kennedy Jr., which critics argue lack a scientific or legal foundation. While studies overwhelmingly support vaccine effectiveness, the lawsuit may face limits because the disputed policies function more as guidance than outright bans—making them harder to contest in court.

The current federal immunization schedule still permits vaccination for children ages six months to 17, but the emphasis on “shared decision-making” between clinicians and parents reflects a softer, less directive stance. This shift raises broader questions about how to hold agencies accountable to long-standing scientific standards, particularly when those standards are increasingly politicized.

For pharmaceutical supply chain leaders, the key risk lies in navigating policy uncertainty. Agencies like CMS and HHS continue to adjust their approaches to vaccines without the traditional public rulemaking processes, as seen in the rollback of the Richardson waiver. These changes reduce transparency and limit stakeholder input, forcing industry to adapt quickly to shifting compliance and operational demands.

The discontinuation of certain mRNA vaccine programs abroad highlights another risk: global regulatory divergence. While the U.S. may reduce emphasis on vaccine leadership, demand will persist in markets across Europe, Asia, Africa, and Latin America. Companies must weigh whether to sustain U.S.-based operations or pivot toward international markets where vaccine adoption remains strong.

Ultimately, if vaccines lose public trust or political backing, funding and development could decline, reshaping regulatory strategy for vaccines and biologics. Supply chain stakeholders must remain vigilant, monitoring both litigation outcomes and evolving federal signals to anticipate potential disruptions.

Videos

Ron Lanton, partner, Lanton Law, explains that declining public trust and political support for vaccines could force pharmaceutical companies to rethink regulatory strategies and investment priorities in biologics and vaccine development.

What Supply Chain Leaders Need to Know About COVID Vaccine Policy Uncertainty

PC: Given the recent lawsuit filed by major medical organizations to restore access to COVID-19 vaccines for children and pregnant people, how might this legal action influence federal authority over vaccine distribution, and what should pharmaceutical supply chain leaders be watching for in terms of compliance risk and operational impact?

The lawsuit seems aimed at challenging federal policies on COVID-19 vaccines, but it faces significant hurdles. The plaintiffs argue that Robert F. Kennedy Jr.’s actions lacked both a legal and scientific basis. There is strong research supporting vaccine effectiveness, and it’s not clear what scientific rationale underpins some of HHS’s decisions.

That said, the lawsuit may have limited impact because of its timing and the nature of Kennedy’s involvement. His actions relate more to guidance than outright bans. He’s not formally refusing or blocking access to vaccines—it’s more of an informal way of restricting access. For example, the agency’s current immunization schedule states that children ages six months to 17 years who are not immunocompromised 

 receive a COVID-19 vaccine, but it frames this as a shared decision between clinicians and parents. That framing raises questions about how federal agencies are being held accountable to long-standing scientific standards, especially as those standards become increasingly politicized.

For supply chain leaders, the key is to monitor not just this lawsuit but broader policy developments within HHS and CMS. Agencies are adjusting vaccine guidance in real time, and many of these changes aren’t publicly debated or transparent. The rollback of the Richardson waiver, for example, means the public no longer sees draft rules, proposed changes, or comments before implementation. That reduces oversight and makes it harder to anticipate regulatory shifts.

Stakeholders should also pay attention to how modifications in funding, leadership, and criteria could influence vaccine approvals and distribution. Recent developments with mRNA vaccines in Europe illustrate this uncertainty. While one country moved away from mRNA, I don’t see that technology disappearing—it’s evolving. The question for U.S. manufacturers is whether to continue operations as is or rethink strategy in light of these shifts. That’s why staying agile and informed is critical for the supply chain right now.

The recent lawsuit filed by major medical organizations to restore broader access to COVID-19 vaccines for children and pregnant people underscores the growing tension between science, law, and politics in federal health policy. The case challenges actions taken under HHS leadership, particularly those linked to Robert F. Kennedy Jr., which critics argue lack a scientific or legal foundation. While studies overwhelmingly support vaccine effectiveness, the lawsuit may face limits because the disputed policies function more as guidance than outright bans—making them harder to contest in court.

Ron Lanton, Partner, Lanton Law, warns that shifting federal policies and ongoing lawsuits could create compliance challenges and operational risks that pharmaceutical supply chain leaders must closely monitor.

GT-02287 Shows Promise in Parkinson's Patients with and Without GBA1 Mutation

, GAIN Therapeutics CEO Gene Mack shared that GT-02287, originally developed for Parkinson’s patients with the GBA1 mutation, is showing early promise in both mutated and idiopathic cases, with a pivotal Phase II trial planned for early 2026 following ahead-of-schedule enrollment in the ongoing Phase Ib study.

How Remote Monitoring Enhances Trial Efficiency and Patient Safety

, Luke Wilson, senior director of biotech and pharma services at Thermo Fisher Scientific, emphasized that remote monitoring improves clinical trial efficiency and patient safety by enabling real-time data access, reducing site burden, and supporting faster, more informed decision-making through integrated, technology-driven systems.

Flu Fighters: Pharmacists Partnering to Protect Communities

Michael Fleck, PharmD, a PGY-1 community-based pharmacy resident, outlines how community pharmacists can drive influenza vaccination uptake by partnering with local organizations, addressing barriers through tailored outreach, and making vaccines more visible, accessible, and trusted within the communities they serve.

Gift Launches $200M Initiative for the Weill Cancer Hub West

A $100 million matching grant from the Weill Family Foundation has launched the Weill Cancer Hub West, a $200 million collaboration between UCSF and Stanford that aims to transform cancer research and care over the next decade through pioneering projects in cellular therapies, AI-powered treatment strategies, precision nutrition, and personalized medicine.

Psyched Perspectives: Trauma, Transformations, and Truth

, psychiatrists Frank A. Clark, MD, and Emily Lafferman, MD, explore themes of trauma, transformation, and truth through poetry and personal reflection, highlighting how creative expression helps clinicians process their own experiences while deepening their connection with patients and each other.

GT-02287, initially targeting Parkinson's patients with the GBA1 mutation, shows promise in both mutated and idiopathic cases, with a Phase II trial set for 2026. Remote monitoring enhances clinical trial efficiency and patient safety by providing real-time data access and reducing site burden. Community pharmacists can increase influenza vaccination rates through partnerships and tailored outreach. A $200 million initiative, including a $100 million grant, aims to advance cancer research at the Weill Cancer Hub West. Creative expression aids psychiatrists in processing trauma and connecting with patients.

Pharma Pulse 8/6/25: GT-02287 Shows Promise in Parkinson's Patients with and Without GBA1 Mutation; How Remote Monitoring Enhances Trial Efficiency and Patient Safety