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Lee M, Lauren BN, Zhan T, et al. The cost-effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity. Obes Sci Pract. 2019;6(2):162-170doi: 10.1002/osp4.390.
Lee, M., Lauren, B. N., Zhan, T., Choi, J., Klebanoff, M., Abu Dayyeh, B., Taveras, E. M., Corey, K., Kaplan, L., & Hur, C. (2020). The cost-effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity. Obesity science & practice, 6(2), 162-170. https://doi.org/10.1002/osp4.390
Lee, Minyi, et al. "The cost-effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity." Obesity science & practice vol. 6,2 (2020): 162-170. doi: https://doi.org/10.1002/osp4.390
Lee M, Lauren BN, Zhan T, Choi J, Klebanoff M, Abu Dayyeh B, Taveras EM, Corey K, Kaplan L, Hur C. The cost-effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity. Obes Sci Pract. 2019 Dec 10;6(2):162-170. doi: 10.1002/osp4.390. eCollection 2020 Apr. PMID: 32313674; PMCID: PMC7156872.
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Obes Sci Pract. 2019 Dec 10;6(2):162-170. doi: 10.1002/osp4.390. eCollection 2020 Apr.

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

Obesity science & practice

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

Affiliations

  1. Gastroenterology Division Massachusetts General Hospital Boston Massachusetts.
  2. Institute for Technology Assessment Massachusetts General Hospital Boston Massachusetts.
  3. Department of General Medicine Columbia University Irving Medical Center New York New York.
  4. Healthcare Innovation Research and Evaluation Columbia University Irving Medical Center New York New York.
  5. Yale School of Medicine New Haven Connecticut.
  6. Division of Gastroenterology and Hepatology Mayo Clinic Rochester Minnesota.
  7. Department of Pediatrics Massachusetts General Hospital Boston Massachusetts.
  8. Harvard Medical School Boston Massachusetts.

PMID: 32313674 PMCID: PMC7156872 DOI: 10.1002/osp4.390

Abstract

BACKGROUND: The Food and Drug Administration has approved several pharmacotherapies for the treatment of obesity. This study assesses the cost-effectiveness of six pharmacotherapies and lifestyle intervention for people with mild obesity (body mass indices [BMIs] 30 to 35).

METHODS: A microsimulation model was constructed to compare seven weight loss strategies plus no treatment: intensive lifestyle intervention, orlistat, phentermine, phentermine/topiramate, lorcaserin, liraglutide, and semaglutide. Weight loss, quality-of-life scores, and costs were estimated using clinical trials and other published literature. Endpoints included costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) with a willingness-to-pay (WTP) threshold of $100 000/QALY. Results were analysed at 1-, 3-, and 5-year time horizons.

RESULTS: At each of the three follow-up periods, phentermine was the cost-effective strategy, with ICERs of $46 258/QALY, $20 157/QALY, and $17 880/QALY after 1, 3, and 5 years, respectively. Semaglutide was the most effective strategy in the 3- and 5-year time horizons, with total QALYs of 2.224 and 3.711, respectively. However, the ICERs were prohibitively high at $1 437 340/QALY after 3 years and $576 931/QALY after 5 years. Deterministic and probabilistic sensitivity analyses indicated these results were robust.

CONCLUSIONS: Phentermine is the cost-effective pharmacologic weight-loss strategy. Although semaglutide is the most effective, it is not cost-effective because of its high price.

© 2019 The Authors. Obesity Science & Practice published by John Wiley & Sons Ltd, World Obesity and The Obesity Society.

Keywords: cost‐effectiveness analysis; obesity; pharmacotherapy; weight loss

Conflict of interest statement

Dr Hur received consulting fees from Novo Nordisk outside the submitted work. Dr Corey received consulting fees from Bristol Myers Squibb, Novo Nordisk, and Gilead outside the submitted work and grant

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