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Economic modeling in patients with obesity and knee osteoarthritis suggests that both semaglutide and tirzepatide would generally be considered cost-effective compared with usual care, with tirzepatide offering the more favorable return on investment once willingness-to-pay thresholds exceed $57,400 per QALY (Betensky et al., 2025)

Similarly, metformin administration commonly induces gastrointestinal disturbances, manifesting as diarrhea, abdominal distension, and nausea 12 , with potentially severe complications including lactic acidosis in rare instances 13

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