Cost-effectiveness of incretin therapies: a Canadian lens on diabetes, obesity, and emerging indications.

Incretin therapies have emerged as key interventions for glycemic control and weight reduction and are now among Canada's costliest outpatient drug classes. This review synthesizes current clinical and economic evidence on the cost-effectiveness of incretin-based therapies. These include glucagon-like peptide-1 receptor agonists (GLP-1RAs; e.g., semaglutide) and dual agonists (e.g., tirzepatide) targeting both glucose-dependent insulinotropic polypeptide and GLP-1 receptors, in patients with type 2 diabetes mellitus or for weight loss. We review data from clinical trials and recent Canadian and international economic models, identify emerging indications, and discuss limitations in current health-technology assessment frameworks. Implications for Canadian reimbursement are highlighted, with attention to price, patient selection, and outcome considerations.