Original Research
Saturday, October 12, 2024
11:30 AM–01:00 PM
Abstract
Introduction:
Obesity affects approximately 42% of the population in the United States. With glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and tirzepatide increasingly used for managing obesity, their cost-effectiveness remains underexplored for weight management in adults.
Research Question or Hypothesis:
Which medication is cost-effective among tirzepatide injection, semaglutide injection, semaglutide tablet, and liraglutide injection for patients with obesity without diabetes?
Study Design:
This study was a cost-effectiveness analysis.
Methods:
We developed a decision tree model to assess the cost-effectiveness of these medications over 68 weeks, extending to 3 and 5 years. The model includes costs of medications, serious adverse events, treatment discontinuation, and weight regain after treatment discontinuation, from a US payer’s perspective. Clinical data were sourced from randomized controlled trials. Costs were calculated in 2024 US dollars. The incremental cost-effectiveness ratio (ICER) was calculated based on the cost per quality-adjusted life year (QALY) gained, using a willingness-to-pay (WTP) threshold of $150,000/QALY. One-way sensitivity analysis for all estimated variables and probabilistic sensitivity analysis were performed to assess the effect of parameter uncertainty on the results.
Results:
In the base-case analysis, tirzepatide injection and semaglutide tablet emerged as cost-effective, dominating liraglutide and semaglutide injections. Tirzepatide injection was more cost effective than semaglutide tablet with ICERs of $34,212 at 68 weeks, $14,388 at year 3, and $10,372 at year 5. Sensitivity analyses indicated that the results were highly sensitive to medication costs and the effect on body mass index reduction. The cost-effectiveness acceptability curves suggested that tirzepatide injection was most likely to be cost effective, with a 90% probability at a WTP of $150,000 per QALY.
Conclusion:
Tirzepatide injection and semaglutide tablet are cost-effective strategies for managing obesity in adults without diabetes than liraglutide and semaglutide injections. These results offer crucial insights for healthcare decision-makers regarding the selection of anti-obesity medications. Further studies are recommended to explore the long-term cost-effectiveness of these treatments.
Presenting Author
Ligang Liu PharmDUse login from my institution
Authors
Jiayu Cui PharmD
CVS Health
Milap C. Nahata PharmD, MS
The Ohio State University College of Pharmacy
Marjorie Neidecker PhD MEng RN CCRP
The Ohio State University College of Pharmacy