---
title: "Real-world patterns and cost per responder for tirzepatide vs semaglutide in US adults with type 2"
id: "pubmed-42808550"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42808550"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42808550/"
doi: "10.18553/jmcp.2026.32.10.1173"
published_at: "2026-10-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Real-world patterns and cost per responder for tirzepatide vs semaglutide in US adults with type 2
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42808550
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42808550/)
- **DOI:** [10.18553/jmcp.2026.32.10.1173](https://doi.org/10.18553%2Fjmcp.2026.32.10.1173)
- **Published At:** 2026-10-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective cohort study used claims and laboratory data from the Healthcare Integrated Research Database to compare real-world treatment patterns, clinical outcomes, and pharmacy cost per patient achieving treatment targets for **tirzepatide** (Mounjaro) versus **semaglutide** (Ozempic) in US adults with type 2 diabetes (T2D). - Patients initiating tirzepatide or semaglutide between May 2022 and May 2023 were propensity score matched and stratified as GLP-1 RA–naive or non-naive based on prior 6-month exposure. - After matching, analyses included 10,702 naive pairs and 5,577 non-naive pairs for each treatment group. - Key treatment-pattern outcomes over 12 months were adherence (proportion of days covered ≥0.80) and persistence (no ≥45-day gap); **tirzepatide** initiators showed higher adherence (naive: 60% vs 45%; non-naive: 66% vs 48%) and persistence (naive: 62% vs 47%; non-naive: 68% vs 49%) compared with **semaglutide** initiators. - A greater proportion of tirzepatide users achieved all reported **A1c** and weight outcomes, including stringent targets: A1c <5.7% (naive: 30% vs 18%; non-naive: 17% vs 6%) and weight loss ≥15% (naive: 23% vs 10%; non-naive: 17% vs 5%). - The study calculated **T2D-Rx cost per responder** as mean T2D-related pharmacy cost divided by the proportion achieving each target. For the most stringent endpoints, tirzepatide had lower cost per responder (eg, A1c <5.7% naive: $45,300 vs $65,300; non-naive: $107,700 vs $270,300; weight loss ≥15% naive: $62,900 vs $124,400; non-naive: $110,200 vs $326,800). - For less stringent A1c goals, T2D-Rx cost per responder was similar between tirzepatide and semaglutide. - The authors conclude tirzepatide showed better adherence, persistence, greater A1c and weight reductions, and lower T2D-Rx cost per responder for the most stringent targets in both naive and non-naive GLP-1 RA subgroups, supporting its clinical and economic value in real-world T2D care. - Conflict of interest: Several authors are employees and stockholders of Eli Lilly and Company; Carelon Research authors received funding from Eli Lilly. Sponsorship was provided by Eli Lilly and Company.
## Clinical Analysis & Structured Key Points
Clipboard, Search History, and several other advanced features are temporarily unavailable. [ Skip to main page content ](https://pubmed.ncbi.nlm.nih.gov/42808550/#article-details) ![U.S. flag](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/favicons/favicon-57.png) An official website of the United States government Here's how you know ![Dot gov](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-dot-gov.svg) **The .gov means it’s official.** Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site. ![Https](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-https.svg) **The site is secure.** The **https://** ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. [ ![NIH NLM Logo](https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/logos/AgencyLogo.svg) ](https://www.ncbi.nlm.nih.gov/) [Log in](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42808550%2F) Show account info Close #### Account Logged in as: **username** * [Dashboard](https://www.ncbi.nlm.nih.gov/myncbi/) * [Publications](https://www.ncbi.nlm.nih.gov/myncbi/collections/bibliography/) * [Account settings](https://www.ncbi.nlm.nih.gov/account/settings/) * [Log out](https://www.ncbi.nlm.nih.gov/account/signout/?back_url=https%3A//pubmed.ncbi.nlm.nih.gov/42808550/) [Access keys](https://www.ncbi.nlm.nih.gov/guide/browsers/#ncbi_accesskeys) [NCBI Homepage](https://www.ncbi.nlm.nih.gov) [MyNCBI Homepage](https://pubmed.ncbi.nlm.nih.gov/myncbi/) [Main Content](https://pubmed.ncbi.nlm.nih.gov/42808550/#maincontent) [Main Navigation](https://pubmed.ncbi.nlm.nih.gov/42808550/) [ ![pubmed logo](https://cdn.ncbi.nlm.nih.gov/pubmed/a447896c-976f-490b-b86b-2668b65114a8/core/images/pubmed-logo-blue.svg) ](https://pubmed.ncbi.nlm.nih.gov/) [ ](https://pubmed.ncbi.nlm.nih.gov/42808550/ "Show search bar") Search: [](https://pubmed.ncbi.nlm.nih.gov/42808550/ "Clear search input")Search [Advanced](https://pubmed.ncbi.nlm.nih.gov/advanced/) [ Clipboard ](https://pubmed.ncbi.nlm.nih.gov/clipboard/) [ User Guide ](https://pubmed.ncbi.nlm.nih.gov/help/) Save Email Send to * [ Clipboard ](https://pubmed.ncbi.nlm.nih.gov/42808550/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42808550%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42808550%2F%23open-collections-panel) * [Citation manager](https://pubmed.ncbi.nlm.nih.gov/42808550/) Display options Display options Format Abstract PubMed PMID ## Save citation to file Format: Summary (text) PubMed PMID Abstract (text) CSV Create file Cancel ## Email citation Email address has not been verified. Go to [ My NCBI account settings ](https://account.ncbi.nlm.nih.gov/settings/) to confirm your email and then refresh this page. To: Subject: Body: Format: Summary Summary (text) Abstract Abstract (text) MeSH and other data Send email Cancel ### Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42808550/) Add Cancel ### Add to My Bibliography * My Bibliography Unable to load your delegates due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42808550/) Add Cancel ## Your saved search Name of saved search: Search terms: [Test search terms](https://pubmed.ncbi.nlm.nih.gov/42808550/) Would you like email updates of new search results? Saved Search Alert Radio Buttons * Yes * No Email: ([change](https://www.ncbi.nlm.nih.gov/account/settings/)) Frequency: Monthly Weekly Daily Which day? The first Sunday The first Monday The first Tuesday The first Wednesday The first Thursday The first Friday The first Saturday The first day The first weekday Which day? Sunday Monday Tuesday Wednesday Thursday Friday Saturday Report format: Summary Summary (text) Abstract Abstract (text) PubMed Send at most: 1 item 5 items 10 items 20 items 50 items 100 items 200 items Send even when there aren't any new results Optional text in email: Save Cancel ## Create a file for external citation management software Create file Cancel ## Your RSS Feed Name of RSS Feed: Number of items displayed: 5 10 15 20 50 100 Create RSS Cancel RSS Link Copy ### Full text links [![Atypon full text link](https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/https:--www.jmcp.org-pb-assets-logos-JMCPLogo.jpg) Atypon ](https://www.jmcp.org/doi/10.18553/jmcp.2026.32.10.1173?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed "See full text options at Atypon") [ Full text links ](https://pubmed.ncbi.nlm.nih.gov/42808550/) ### Actions Cite Collections Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42808550/) Add Cancel Permalink Permalink Copy Display options Display options Format Abstract PubMed PMID ### Experimental Resource Linked Discoveries ### Page navigation * [ Title & authors ](https://pubmed.ncbi.nlm.nih.gov/42808550/#heading) * [ Abstract ](https://pubmed.ncbi.nlm.nih.gov/42808550/#abstract) * [ Conflict of interest statement ](https://pubmed.ncbi.nlm.nih.gov/42808550/#conflict-of-interest) * [Similar articles](https://pubmed.ncbi.nlm.nih.gov/42808550/#similar) * [ References ](https://pubmed.ncbi.nlm.nih.gov/42808550/#references) * [ MeSH terms ](https://pubmed.ncbi.nlm.nih.gov/42808550/#mesh-terms) * [ Substances ](https://pubmed.ncbi.nlm.nih.gov/42808550/#substances) * [Related information](https://pubmed.ncbi.nlm.nih.gov/42808550/#related-links) * [ LinkOut - more resources ](https://pubmed.ncbi.nlm.nih.gov/42808550/#linkout) Title & authors Abstract Conflict of interest statement Similar articles References MeSH terms Substances Related information LinkOut - more resources J Manag Care Spec Pharm Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Manag+Care+Spec+Pharm%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Manag+Care+Spec+Pharm%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42808550/) . 2026 Oct;32(10):1173-1188. doi: 10.18553/jmcp.2026.32.10.1173. # Real-world treatment patterns and cost per patient achieving treatment targets among tirzepatide and semaglutide initiators in US patients with type 2 diabetes [Meredith M Hoog](https://pubmed.ncbi.nlm.nih.gov/?term=Hoog+MM&cauthor_id=42808550)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#full-view-affiliation-1 "Eli Lilly and Company, Indianapolis, IN."), [Carlos Vallarino](https://pubmed.ncbi.nlm.nih.gov/?term=Vallarino+C&cauthor_id=42808550)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#full-view-affiliation-1 "Eli Lilly and Company, Indianapolis, IN."), [Juan M Maldonado](https://pubmed.ncbi.nlm.nih.gov/?term=Maldonado+JM&cauthor_id=42808550)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#full-view-affiliation-1 "Eli Lilly and Company, Indianapolis, IN."), [Michael Grabner](https://pubmed.ncbi.nlm.nih.gov/?term=Grabner+M&cauthor_id=42808550)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#full-view-affiliation-2 "Carelon Research, Wilmington, DE."), [Chia-Chen Teng](https://pubmed.ncbi.nlm.nih.gov/?term=Teng+CC&cauthor_id=42808550)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#full-view-affiliation-2 "Carelon Research, Wilmington, DE."), [Kendra Terrell](https://pubmed.ncbi.nlm.nih.gov/?term=Terrell+K&cauthor_id=42808550)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#full-view-affiliation-1 "Eli Lilly and Company, Indianapolis, IN."), [Emma L Richard](https://pubmed.ncbi.nlm.nih.gov/?term=Richard+EL&cauthor_id=42808550)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#full-view-affiliation-2 "Carelon Research, Wilmington, DE.") Affiliations Expand ### Affiliations * 1 Eli Lilly and Company, Indianapolis, IN. * 2 Carelon Research, Wilmington, DE. * PMID: **42808550** * PMCID: **PMC13621902** (available on 2026-10-01) * DOI: [ 10.18553/jmcp.2026.32.10.1173 ](https://doi.org/10.18553/jmcp.2026.32.10.1173) Item in Clipboard # Real-world treatment patterns and cost per patient achieving treatment targets among tirzepatide and semaglutide initiators in US patients with type 2 diabetes Meredith M Hoog et al. J Manag Care Spec Pharm. 2026 Oct. Show details Display options Display options Format Abstract PubMed PMID J Manag Care Spec Pharm Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Manag+Care+Spec+Pharm%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Manag+Care+Spec+Pharm%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42808550/) . 2026 Oct;32(10):1173-1188. doi: 10.18553/jmcp.2026.32.10.1173. ### Authors [Meredith M Hoog](https://pubmed.ncbi.nlm.nih.gov/?term=Hoog+MM&cauthor_id=42808550)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#short-view-affiliation-1 "Eli Lilly and Company, Indianapolis, IN."), [Carlos Vallarino](https://pubmed.ncbi.nlm.nih.gov/?term=Vallarino+C&cauthor_id=42808550)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#short-view-affiliation-1 "Eli Lilly and Company, Indianapolis, IN."), [Juan M Maldonado](https://pubmed.ncbi.nlm.nih.gov/?term=Maldonado+JM&cauthor_id=42808550)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#short-view-affiliation-1 "Eli Lilly and Company, Indianapolis, IN."), [Michael Grabner](https://pubmed.ncbi.nlm.nih.gov/?term=Grabner+M&cauthor_id=42808550)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#short-view-affiliation-2 "Carelon Research, Wilmington, DE."), [Chia-Chen Teng](https://pubmed.ncbi.nlm.nih.gov/?term=Teng+CC&cauthor_id=42808550)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#short-view-affiliation-2 "Carelon Research, Wilmington, DE."), [Kendra Terrell](https://pubmed.ncbi.nlm.nih.gov/?term=Terrell+K&cauthor_id=42808550)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#short-view-affiliation-1 "Eli Lilly and Company, Indianapolis, IN."), [Emma L Richard](https://pubmed.ncbi.nlm.nih.gov/?term=Richard+EL&cauthor_id=42808550)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42808550/#short-view-affiliation-2 "Carelon Research, Wilmington, DE.") ### Affiliations * 1 Eli Lilly and Company, Indianapolis, IN. * 2 Carelon Research, Wilmington, DE. * PMID: **42808550** * PMCID: **PMC13621902** (available on 2026-10-01) * DOI: [ 10.18553/jmcp.2026.32.10.1173 ](https://doi.org/10.18553/jmcp.2026.32.10.1173) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Background:** Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist (RA), and semaglutide, a GLP-1 RA, are approved for type 2 diabetes (T2D) management. Clinical trials demonstrated that tirzepatide provided greater hemoglobin A1c and weight reduction vs comparators. Studies using trial-based effect estimates indicate it may also offer a lower cost per patient achieving treatment targets. However, real-world comparative data on treatment patterns, effectiveness, and economic value are limited. **Objective:** To compare real-world treatment patterns, A1c and weight outcomes, and type 2 diabetes-related pharmacy (T2D-Rx) costs per patient achieving treatment targets in patients initiating tirzepatide for T2D, stratified by prior GLP-1 RA use. **Methods:** This retrospective cohort study used claims and laboratory data from the Healthcare Integrated Research Database. Adults with T2D initiating tirzepatide (Mounjaro only) or semaglutide (Ozempic only) from May 2022 to May 2023 were propensity score matched and classified as naive or non-naive based on GLP-1 RA exposure in the 6 months before initiation. Outcomes over 12 months of follow-up included adherence (proportion of days covered ≥0.80), persistence (no ≥45-day gap), and T2D-Rx cost per responder (mean T2D-related pharmacy cost ÷ proportion achieving treatment target) to achieve A1c ( 2. 1. American Diabetes Association . Economic costs of diabetes in the U.S. in 2017. _Diabetes Care_. 2018;41(5):917-28. doi: 10.2337/dci18-0007 - [DOI](https://doi.org/10.2337/dci18-0007) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC5911784/) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/29567642/) 3. 1. Dieleman JL, Baral R, Birger M, et al. US spending on personal health care and public health, 1996-2013. _JAMA_. 2016;316(24):2627-46. doi: 10.1001/jama.2016.16885 - [DOI](https://doi.org/10.1001/jama.2016.16885) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC5551483/) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/28027366/) 4. 1. Dieleman JL, Cao J, Chapin A, et al. US health care spending by payer and health condition, 1996-2016. _JAMA_. 2020;323(9):863-84. doi: 10.1001/jama.2020.0734 - [DOI](https://doi.org/10.1001/jama.2020.0734) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC7054840/) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/32125402/) 5. 1. ElSayed NA, Aleppo G, Aroda VR, et al. ; on behalf of the American Diabetes Association . 6. Glycemic targets: standards of care in diabetes-2023. _Diabetes Care_. 2023;46(suppl 1):S97-S110. doi: 10.2337/dc23-S006 - [DOI](https://doi.org/10.2337/dc23-s006) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC9810469/) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/36507646/) Show all 45 references ## MeSH terms * Adult Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adult%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adult) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42808550/) * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42808550/) * Diabetes Mellitus, Type 2* / drug therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Diabetes+Mellitus%2C+Type+2%2Fdrug+therapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Diabetes+Mellitus%2C+Type+2) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42808550/) * Diabetes Mellitus, Type 2* / economics Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Diabetes+Mellitus%2C+Type+2%2Feconomics%22%5BMAJR%5D&sort=date&sort_order=desc)
## Related Clinical Research

- [Factors Driving Weight Loss Variability with GLP-1 Receptor Agonists and Dual Agonists in Obesity:](https://medichelpline.com/clinical-feed/pubmed-42733128.md) (DOI: 10.1111/cob.70112)
- [GLP‑1 and Dual GIP/GLP‑1 Receptor Agonists: Psychopharmacology and Potential Neuropsychiatric Effe](https://medichelpline.com/clinical-feed/pubmed-42624955.md) (DOI: 10.1007/s11920-026-01709-w)
- [Semaglutide plus menopause hormone therapy linked to greater weight loss in midlife women](https://medichelpline.com/clinical-feed/medical-news-today-0-ozempic-plus-hormone-therapy-may-help-boost-weight-loss-at-menopause.md)
- [Digital-first delivery of GLP-1RA therapy in 8,127 women](https://medichelpline.com/clinical-feed/nature-3-real-world-digital-first-delivery-of-glp-1-receptor-agonist-therapy-in-women.md)
- [Semaglutide preserves kidney function in type 2 diabetes: mechanisms from the REMODEL randomized t](https://medichelpline.com/clinical-feed/nature-1-effects-of-semaglutide-on-kidney-disease-in-type-2-diabetes-a-randomized.md)

## Navigation
- [← Back to Pharmacology Feed](https://medichelpline.com/clinical-feed/pharmacology.md)
- [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md)
## Medical & Regulatory Disclaimer

> [!CAUTION]
> MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations.
> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.