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ForumsCardiovascular OutcomesSELECT cost-effectiveness — NNT analysis for MACE prevention Page 3

SELECT cost-effectiveness — NNT analysis for MACE prevention

HealthEcon_DC Thu, Jun 4, 2026 at 7:17 AM 13 replies 458 viewsPage 3 of 3
mark_tokyo
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Jun 6, 2026 at 2:51 PM#11
newstart_MO said:
Denials are usually procedural rather than clinical, and the order that works reflects that.

This answered a question I did not know how to ask. Printing the relevant bit and taking it with me.

1 1pete_manc_UK
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KevinCompounds
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Jun 7, 2026 at 2:53 AM#12

Adding the clinical framing, because it changes how the question reads.

Continuous metabolic monitoring dashboard for cardiovascular risk — I track everything in a spreadsheet and here's the month-over-month trend for my key markers:

Weight: consistent downtrend, -2.4 lbs/week average
Fasting glucose (finger stick): stable at 87 mg/dL
Blood pressure (home): 119/73 average
Resting heart rate: 67 bpm (down from 83)
Waist circumference: down 17 inches total

The resting heart rate improvement correlates with cardiovascular fitness gains. Everything is moving in the right direction.

50 0Dr.RaviCardio, jennifer_SEA, tyler_CSCS and 47 others
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BariatricNurseD
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Jun 7, 2026 at 2:55 PM#13
Dr.RenalNash said:
Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history.

Pushing back on Dr.RenalNash here. The affordability discussion here usually stops at individual tactics. At list price this class is out of reach for most of the people who would benefit, and no amount of appeal strategy changes that — it is a pricing problem wearing a paperwork costume.

Last edited: Jun 7, 2026 at 7:55 PM
49 24josh_phd_bmore, roxy_nash, tony_orlando and 46 others
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SleepDoc_PDX
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Jun 8, 2026 at 2:57 AM#14
HealthEcon_DC said:
SELECT is the trial that changed the framing of this class, because it was an outcome trial rather than a weight trial: about a 20% relative reduction…
HealthEcon_DC said:
...cardiovascular risk is just another fad...

I understand the skepticism — we've all seen "miracle" weight loss solutions come and go. But consider what makes GLP-1 agonists different:

  • Phase 3 RCTs with thousands of participants (not 20-person pilot studies)
  • Published in NEJM, JAMA, Lancet (not press releases)
  • Replicated across multiple independent research groups
  • Proven cardiovascular and renal benefits beyond weight loss
  • Biological mechanism fully characterized at the receptor level

This isn't a fad — it's a new drug class supported by the highest level of clinical evidence. The comparison to past fads is understandable but inappropriate.

Last edited: Jun 8, 2026 at 5:57 AM
48 23sophie_paris, mel_PDX, Dr.AddMedPHL and 45 others
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Admin
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Jun 8, 2026 at 2:59 PM#15

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Thread quality here is what the rules are for. Keep it up.

Last edited: Jun 8, 2026 at 6:59 PM
47 22PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 44 others
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