Semaglutide Reduces Time in Spent in Hospital, Admission Rates in Patients With Overweight or Obesity

In a prespecified exploratory analysis of the SELECT randomized clinical trial (NCT03574597), once-weekly semaglutide (Ozempic, Wegovy; Novo Nordisk) was associated with meaningful reductions in hospital admissions and overall time spent in the hospital in patients with overweight or obesity, according to research published by investigators in JAMA Cardiology.^1,2

The results affirm the long-term benefits of semaglutide beyond cardiovascular risk reduction. By reducing the burden of total hospital admissions for any indication, treatment with semaglutide has the potential to revolutionize weight management and offer transformative health impacts to patients with obesity or overweight.¹

“The findings highlight that these patients are at risk of a whole host of clinical complications,” Stephen J. Nicholls, MD, program director of Victorian Heart Hospital in Victoria, Australia, and corresponding author of the study, said in an interview with Pharmacy Times. “The benefits of total hospitalization have important implications for more holistic approaches to treatment and are important from a health service and payer perspective.”

How Did Semaglutide Reduce Broader Hospitalization Risk?

A total of 17,604 patients who were previously enrolled in the SELECT clinical trial were followed up for a median of 41.8 months. The investigators compared the effects of semaglutide to those from placebo.¹

Patients treated with semaglutide were less likely to experience any hospital admission (33.4% vs 36.7%; HR, 0.89; 95% CI, 0.84–0.93; P < .001); a hospital admission was recorded as a serious adverse event (30.3% vs 33.4%; HR, 0.88; 95% CI, 0.84–0.93; P < .001); and an elective hospitalization (6.3% vs 7.3%; HR, 0.86; 95% CI, 0.77–0.97; P = .01). Reductions in hospital admission risk were observed across differing indications, including cardiac, respiratory, and infections.¹

Throughout the follow-up period, a total of 11,287 hospital admissions occurred. The investigators observed a lower number of total hospitalizations among patients treated with semaglutide compared with the placebo group for all indications (18.3 vs 20.4 admissions per 100 patient-years; MR, 0.90; 95% CI, 0.85–0.95; P < .001) and for serious adverse events (15.2 vs 17.1 admissions per 100 patient-years; MR, 0.89; 95% CI, 0.84–0.94; P < .001). Furthermore, there were a lower number of days hospitalized per 100 patient-years in the semaglutide group compared with the placebo group for all hospitalizations (157.2 vs 176.2 days; RR, 0.89; 95% CI, 0.82–0.98; P = .01) and hospitalizations for serious adverse events (137.6 vs 153.9 days; RR, 0.89; 95% CI, 0.81–0.98; P = .02).¹

How Pharmacists Can Ensure Adherence to and Convey the Benefits of Semaglutide

When asked about the role of pharmacists in identifying patients eligible for semaglutide therapy and in monitoring medication adherence, Nicholls explained that “prevention is a team sport.”

“Pharmacists are vital members of the team,” Nicholls said. “They play an important role both at the start, when we are deciding who to initiate therapy [for] and how, but just as importantly in the long term to monitor for both tolerability and promoting adherence. These are chronic therapies, so we need patients to be taking them in the long term.”

Based on these results, treatment with semaglutide stands to reduce the risk of hospitalizations caused by a series of comorbidities, in addition to decreases in admission for surgical and medical procedures. Semaglutide can offer patients with overweight or obesity a spectrum of benefits that are not limited to reductions in major adverse cardiovascular event risk.¹

The authors referenced the weight loss effects observed in the original SELECT trial with semaglutide, with the glucagon-like peptide-1 receptor agonist (GLP-1 RA) leading to greater mean weight loss versus placebo (–9.39% vs –0.88%). They discussed that this weight loss in patients treated with semaglutide could confer additional benefits, leading to a favorable effect on hospitalizations. Additionally, GLP-1 RAs have been shown to offer direct effects on vascular tissues while reducing inflammation and improving immune function, which could have contributed to the reduced hospitalization risk seen in patients treated with semaglutide.^1,3,4

Nicholls emphasized that patients should “play an active role in the decision-making about their health care.” By doing so, pharmacists can assist in addressing concerns surrounding adherence and polypharmacy while working to minimize barriers to semaglutide use in real-world practice.

“[The patient should have] an understanding of what the problems are, what the objective of treatment [is], how those treatments work, what side effects might be expected­­—or at least should be looked out for—and the importance of long-term adherence,” Nicholls explained. “Pharmacists play a critical role in working with patients, so they do understand these elements.”

REFERENCES

1. Nicholls SJ, Ryan DH, Deanfield J, et al. Semaglutide and hospitalizations in patients with obesity and established cardiovascular disease: An exploratory analysis of the SELECT randomized clinical trial. JAMA Cardiol. Published Online December 23, 2025. Accessed February 2, 2026. doi:10.1001/jamacardio.2025.4824

2. Semaglutide effects on heart disease and stroke in patients with overweight or obesity (SELECT). ClinicalTrials.gov Identifier: NCT03574597. Last Updated August 30, 2024. Accessed February 2, 2026. https://clinicaltrials.gov/study/NCT03574597

3. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563

4. Sattar N, Lee MMY. Estimating direct tissue effects versus weight loss effects of incretin-based drugs for obesity on various chronic conditions. The Lancet Diabetes & Endocrinology. 2025;13(4):347-354. doi:10.1016/S2213-8587(24)00363-2