GLP-1 Therapy and the Reshaping of Socioeconomic Gradients in Health -- by J. Felipe Montano-Campos, Bryan Tysinger, Dana Goldman, Darius N. Lakdawalla

GLP-1 therapies for obesity promise substantial health improvements, but little is known about how their benefits vary across socioeconomic and demographic groups. Using a nationally representative microsimulation model of US adults and Shapely-value decomposition, we estimate the lifetime health and economic benefits of GLP-1 treatment and examine how those gains vary across individuals. The largest differences emerge across education. Individuals with less than a high school education experience experience roughly 14% higher gains in lifetime net social value, 16-17% larger improvements in discounted generalized risk- and severity-adjusted life-years (GRASA-QALYs), and 20% greater increases in life expectancy relative to the cohort mean, whereas individuals with college degrees experience gains 15-27% below the mean across these outcomes. Black and Hispanic individuals also tend to experience larger improvements in health outcomes and social value than White individuals, including larger gains in GRASA-QALYs and life expectancy and larger reductions in diabetes risk and duration. Females likewise experience larger predicted treatment gains than men. These patterns are consistent with the idea that the largest gains arise among populations facing greater socioeconomic constraints in sustaining behavioral weight control. GLP-1 innovation may therefore mitigate inequality in obesity-related disease and survival, advancing equity in population health.