Cost-effectiveness analysis of 4 GLP-1RAs in the treatment of obesity in a US setting

Abstract

Background: The number of obese people continues to increase worldwide, and obesity-related complications add to every country's health burden. Consequently, new weight-loss medications, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), are attracting increasing attention. This study sought to assess the cost effectiveness for weight loss of 4 GLP-1RAs in adult patients with obesity in the United States.Methods: Four GLP-1RA groups that received Liraglutide (1.8 mg QD), Semaglutide (1.0 mg QW), Dulaglutide (1.5 mg QW), or Exenatide (10 μg BID), and one no-treatment group were compared using a decision-tree model. All the estimated parameters were derived from published articles. Quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs) were adopted as the study endpoints.We analyzed the results with the willingness-to-pay (WTP) threshold, and conducted deterministic and probabilistic sensitivity analyses. Results:The GLP-1RAs produced effective weight-loss results; however, not all the GLP-1RAs were cost effective compared to no treatment based on a WTP threshold of $195000/QALY. Among the 4 GLP-1RAs, Semaglutide provided a cost-effective strategy with an ICER of $135467/QALY. The sensitivity analyses showed that these results are reliable.Conclusions: Among the 4 GLP-1RAs, Semaglutide was the most cost-effective obesity medication.

Effects of treatment with Glucagon‐like peptide‐1 receptor agonist on prediabetes with overweight/obesity: A systematic review and meta‐analysis

“…As a long‐term weight‐control therapy, semaglutide 2.4 mg is estimated to be cost effective compared to untreated D&E alone 40 . Among the four GLP‐1RAs including liraglutide (1.8 mg QD), semaglutide (1.0 mg, once per week), dulaglutide (1.5 mg once per week), or exenatide (10μg, twice per day), semaglutide provided a cost‐effective strategy with an incremental cost‐effectiveness ratio of $135,467/quality‐adjusted life years (QALY) 41 . The use of GLP‐1 agonists to reverse prediabetes with overweight/obesity may be economically feasible and sustainable.…”

Tirzepatide versus semaglutide for weight loss in patients with type 2 diabetes mellitus: A value for money analysis

“…3,15 A recent study attempted to calculate quality-adjusted life years indirectly for glucagon-like peptide-1 agonists based on existing data and found that semaglutide was the most costeffective of the drugs tested. 16 Tirzepatide is first in a new drug class that also induces clinically relevant weight reduction.…”

Economic evaluation of using polygenic risk score to guide risk screening and interventions for the prevention of type 2 diabetes in individuals with high overall baseline risk

“…Also, we did not model the adverse effects of liraglutide since the most common adverse effects of liraglutide 3.0 mg are nausea and diarrhea (as compared to placebo) ( Pi-Sunyer et al, 2015 ) and the evaluation of impacts of the most common adverse effects (i.e., nausea, diarrhea) on QoL is challenging and available data is limited. Therefore, for example, recently published studies have not considered the impacts of adverse effects of liraglutide ( Shah et al, 2018 ; Lee et al, 2020 ; Hu et al, 2022 ). Thus, for simplicity, we did not consider the impacts of adverse effects on QoL or costs.…”