Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Hepatol. Oct 27, 2026; 18(10): 123353
Published online Oct 27, 2026. doi: 10.4254/wjh.123353
Published online Oct 27, 2026. doi: 10.4254/wjh.123353
Cost-utility analysis of glucagon-like peptide-1 receptor agonists for type 2 diabetes mellitus and metabolic dysfunction-associated steatotic liver disease in Thailand
Sirada Limwongse, Paninnuch Chatpattanasiri, Phonnaphat Phuphuang, Krisada Tungthaweethong, Keerati Sutheerayongprasert, Watkornphat Aunprom-Me, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Chayanis Kositamongkol, Pochamana Phisalprapa, Division of Ambulatory Medicine, De
Co-first authors: Sirada Limwongse and Paninnuch Chatpattanasiri.
Author contributions: Kositamongkol C and Phisalprapa P designed the study; Limwongse S, Chatpattanasiri P, Phuphuang P, Tungthaweethong K, Sutheerayongprasert K, Aunprom-Me W and Kositamongkol C collected and analyzed the data; Limwongse S, Chatpattanasiri P, Phuphuang P, Tungthaweethong K, Sutheerayongprasert K, Aunprom-Me W and Kositamongkol C performed the manuscript preparation; Kositamongkol C and Phisalprapa P participated in the review and editing; all authors have read and approved the final manuscript. Limwongse S and Chatpattanasiri P contributed equally to this work as co-first authors.
AI contribution statement: Portions of this manuscript were edited using AI tools (Perplexity) solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Institutional animal care and use committee statement: Not applicable, as this study did not involve animal subjects.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board at the Faculty of Medicine Siriraj Hospital, Mahidol University, No. Si-568/2024.
Informed consent statement: The informed consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Pochamana Phisalprapa, MD, PhD, Associate Professor, Lecturer, Senior Researcher, Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, No. 2 Wanglang Road, Siriraj, Bangkok Noi, Bangkok 10700, Thailand. pochamana.phi@mahidol.ac.th
Received: May 18, 2026
Revised: July 17, 2026
Accepted: September 15, 2026
Published online: October 27, 2026
Processing time: 158 Days and 22.4 Hours
Revised: July 17, 2026
Accepted: September 15, 2026
Published online: October 27, 2026
Processing time: 158 Days and 22.4 Hours
Core Tip
Core Tip: This cost-utility analysis evaluated semaglutide and liraglutide for adults with type 2 diabetes mellitus and metabolic dysfunction-associated steatotic liver disease in Thailand. Using a lifetime Markov model, we found that the incremental cost-effectiveness ratios of both drugs, relative to usual care, exceeded the national willingness-to-pay threshold. Neither drug was therefore cost-effective. Achieving cost-effectiveness would require price reductions exceeding 90%. These findings underscore the urgent need for drug price negotiations to improve treatment access within Thailand’s heal