Universal Semaglutide Access Could Save 28 Million Lives in 5 Years, Study Finds

A global study suggests expanding access to semaglutide could save 28 million lives globally over the next 5 years.

Results of the study, which were presented at the 85th Scientific Sessions of the American Diabetes Association (ADA 2025), suggest universal access could significantly reduce the burden of type 2 diabetes, obesity, and related health outcomes worldwide.

Led by investigators from Emory University, the study aimed to estimate the potential public health impact of providing universal access to semaglutide across 196 countries. Using a validated microsimulation model, researchers integrated age-, sex-, and country-specific prevalence and incidence data from the 2021 Global Burden of Disease and NCD-RisC studies. The model assessed the 5-year impact of universal semaglutide access on type 2 diabetes, obesity, cardiovascular disease, chronic kidney disease, stroke, end-stage kidney disease, and all-cause mortality.

Of the estimated 6.1 billion adults globally, 19.0%—or over 1.1 billion individuals—met eligibility criteria for semaglutide treatment based on a global prevalence of 8.76% for type 2 diabetes and 16.4% for obesity.

The simulation projected that universal access to semaglutide could reduce 5-year all-cause mortality by 7.41%, translating to approximately 28 million fewer deaths (absolute change: –0.29%; 95% CI, –0.47 to –0.10%). It could also lower global obesity prevalence by 21.9%, or about 330 million fewer people with obesity (absolute change: –5.42%; 95% CI, –6.48 to –4.36%).

For more on this study and the results, check out our Q&A interview with presenting author Elizabeth Staton-Mitchell, BA, a PhD student at Emory University, from the floor at ADA 2025.

Exploring the Impact of Universal GLP-1 RA Access

HCPLive: This study doesn’t necessarily impact clinical care today, but it raises a powerful “what if” scenario. Before we dive into the specifics, were you surprised by the effect size and outcomes in this microsimulation?

Statton: Definitely, and we went through a lot of rounds of validation—like, is this correct?—because the results had a shock value. When we initially prepared the abstract, our estimates were a bit lower. And when we framed the findings as a percentage point change in mortality or obesity prevalence, it seemed modest—say 9% of cases avoided—but that actually represents a 50% reduction in total prevalence. That’s a huge impact. One key point that often gets missed is the downward shift in obesity class—class 3 to class 2, class 2 to class 1. The headline about a 50% reduction only reflects class 1 to no obesity, but the broader improvement across severity levels is also really important.

HCPLive: A major debate around GLP-1s has been about access and affordability—particularly for those who need them most. Did your team investigate the potential cost or cost-effectiveness of universal access?

Statton: Yeah, that’s definitely a future area of research for our team and Dr. Shao’s group. We often study subgroup-specific cost-effectiveness and try to identify the highest-benefit users. Given the limits on supply, access, and cost, our goal would be to find the people for whom these therapies would offer the greatest public health return.

HCPLive: Looking at the results overall, which statistics or takeaways do you think best highlight the value of getting these therapies into the hands of patients?

Statton: It’s tough to balance the population-level versus individual-level perspective. A 50% reduction in obesity is striking, but what that means for a single patient is less direct. We used clinical trial-based BMI reductions, and the typical drop over a year was about five BMI points. As a statistician, you can translate that into probabilities, but it doesn’t always click at the patient level. Still, if you're treating a broad population, you should expect substantial benefits in both obesity and mortality.

HCPLive: You estimate millions of lives saved over 5 years. Was this mortality benefit mostly tied to reduced obesity itself, or more so to the downstream effects on other diseases like cardiovascular or kidney disease?

Statton: That’s a great question. We used peer-reviewed disease risk equations, and for nearly every condition we modeled—CKD, cardiovascular disease, end-stage renal failure—obesity was a major risk multiplier. So, the reduction in obesity-related morbidity really drove the mortality benefit. In the Americas, for example, the impact came largely from chronic diseases like cardiovascular disease. In other regions, competing health risks diluted the mortality benefit somewhat.

HCPLive: How do you view the relevance of these findings from a broader public health standpoint?

Statton: We really hope this serves as a conversation starter. No one’s asked this "what if" question at scale before using simulation. We’ve been framing it as: imagine 25 years from now—we’ve solved the supply chain, there are generics, and everyone who needs these drugs has access. Ideally, this can help guide policy, influence pricing discussions with pharma, and promote a global conversation that extends beyond the U.S. and European markets.

Staton-Mitchell has no relevant disclosures to report.

References:

Staton E, Li P, Lee J, et al. Universal Access to GLP1-RAs Could Reduce Global Obesity Prevalence by 20% and Save 28 Million Lives over Five Years–A Microsimulation Study. Presented at: 85th American Diabetes Association Scientific Sessions. June 20 – 23, 2025. Chicago, Illinois.