The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity

Lee, Minyi; Lauren, Brianna N.; Zhan, Tiannan; Choi, Jin; Klebanoff, Matthew J.; Dayyeh, Barham Abu; Taveras, Elsie M.; Corey, Kathleen E.; Kaplan, Lee M.; Hur, Chin

doi:10.1002/osp4.390

Cited by 38 publications

(44 citation statements)

References 43 publications

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“…Currently, very few weight-loss drugs have been approved for use by the FDA, other than Lorcaserin and Orlistat, which have relatively modest clinical efficacy and have not been widely used in clinical practice or well known to the public (24). Additionally, phentermine is not the best choice for cardiovascular disease patients because of its adverse effects even if it has a better curative effect (25).…”

Section: Discussionmentioning

confidence: 99%

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

Hu¹,

Zheng²,

Ye³

et al. 2022

Ann Transl Med

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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.

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Section: Discussionmentioning

confidence: 99%

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

Hu¹,

Zheng²,

Ye³

et al. 2022

Ann Transl Med

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“…Only 2.4 and 2.2% of participants receiving continued semaglutide and placebo, respectively, discontinued treatment because of adverse events with one death reported in each group attesting to the safety of maintenance therapy. Lee et al [26 ▪ ] assessed cost-effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity and reported that semaglutide was the most effective strategy in the 3-and 5-year time horizons, with total quality-adjusted life years (QALYs) of 2.224 and 3.711, respectively but, the incremental cost-effectiveness ratios were prohibitively high at $1437 340/QALY after 3 years and $576931/QALY after 5 years its high price. If semaglutide is made more affordable, this effective therapy will be available to more individuals with obesity and can be cost effective.…”

Section: Discussionmentioning

confidence: 99%

Semaglutide for weight loss and cardiometabolic risk reduction in overweight/obesity

Mares

Chatterjee

Mukherjee

2022

Current Opinion in Cardiology

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Purpose of reviewCardiovascular disease is the most common cause of morbidity and mortality worldwide, and the risk is heightened in the presence of obesity. We review semaglutide, a drug recently approved for chronic weight management in adults with obesity or who are overweight. Recent findingsOn 4 June 2021, the US Food and Drug Administration approved semaglutide injection at 2.4 mg once weekly for chronic weight management in adults with obesity or overweight with at least one weight-related condition such as high blood pressure, type 2 diabetes mellitus, or high cholesterol. This subcutaneous injection is the first approved drug for chronic weight management in adults with general obesity or overweight since 2014. The drug is indicated for weight management in patients with a BMI of 27 kg/m 2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m 2 or greater. SummarySemaglutide offers adults with obesity or overweight a new treatment in conjunction with a weight management program consisting of reduced calorie diet and increased physical activity.

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“… 58 However, for the treatment of obesity, semaglutide was found to be not as cost-effective as other obesity pharmacotherapy due to its relatively higher costs, despite its more significant clinical impact than other drug therapies for obesity. 59 Of note, the abovementioned studies do not include evidence from recently published STEP studies. Further cost-effectiveness studies of semaglutide in people with obesity will be supported by the ongoing SELECT (Semaglutide effects on heart disease and stroke in patients with overweight or obesity; ClinicalTrials.gov identifier: NCT03574597) study investigating major adverse cardiovascular outcomes in people who were overweight or obese without T2D.…”

Section: Cost-effectiveness Of Glp-1ras In Obesitymentioning

confidence: 99%

Glucagon-like Peptide-1 Receptor Analogues for the Treatment of Obesity

Williams¹,

Staff²,

Bain³

et al. 2022

Endocrinology

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There is an increasing prevalence of obesity worldwide, associated with significant morbidity and mortality, which frequently reduces quality of life and life expectancy. Consequently, there is a substantial and growing personal and economic burden necessitating the development of more effective therapies for obesity. Glucagon-like peptide-1 receptor analogues (GLP-1RAs) are licensed for the treatment of type 2 diabetes (T2D), and there is substantial evidence that these drugs not only improve cardiovascular outcomes but also promote weight loss. More recent evidence supports the use of the GLP-1RAs liraglutide and semaglutide in people with obesity without T2D. This article discusses the results of the major cardiovascular outcome trials for GLP-1RAs in people with T2D, the SCALE Obesity and Prediabetes study (Effect of liraglutide on body weight in non-diabetic obese subjects or overweight subjects with co-morbidities: SCALE™ - Obesity and Pre-diabetes; ClinicalTrials.gov identifier: NCT01272219; investigating liraglutide) and the STEP studies (Semaglutide treatment effect in people with obesity; assorted studies; investigating subcutaneous semaglutide). We also highlight the importance of a cost-effective approach to obesity pharmacotherapy. Clinicians should consider the use of GLP-1RAs in people with obesity, especially those with T2D or other obesity-related diseases, such as hypertension and dyslipidaemia. Ongoing trials, as well as clinical and cost-effectiveness appraisals, are anticipated over the next 12 months, and their findings may change the current landscape of obesity pharmacotherapy.

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The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity

Cited by 38 publications

References 43 publications

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

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

Semaglutide for weight loss and cardiometabolic risk reduction in overweight/obesity

Glucagon-like Peptide-1 Receptor Analogues for the Treatment of Obesity

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