The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity
Summary 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 microsim...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-04-01
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| Series: | Obesity Science & Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/osp4.390 |
| _version_ | 1819140247347265536 |
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| author | Minyi Lee Brianna N. Lauren Tiannan Zhan Jin Choi Matthew Klebanoff Barham Abu Dayyeh Elsie M. Taveras Kathleen Corey Lee Kaplan Chin Hur |
| author_facet | Minyi Lee Brianna N. Lauren Tiannan Zhan Jin Choi Matthew Klebanoff Barham Abu Dayyeh Elsie M. Taveras Kathleen Corey Lee Kaplan Chin Hur |
| author_sort | Minyi Lee |
| collection | DOAJ |
| description | Summary 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. |
| first_indexed | 2024-12-22T11:35:31Z |
| format | Article |
| id | doaj.art-7fdec99a4b1c4655852f85d7580c9803 |
| institution | Directory Open Access Journal |
| issn | 2055-2238 |
| language | English |
| last_indexed | 2024-12-22T11:35:31Z |
| publishDate | 2020-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Obesity Science & Practice |
| spelling | doaj.art-7fdec99a4b1c4655852f85d7580c98032022-12-21T18:27:26ZengWileyObesity Science & Practice2055-22382020-04-016216217010.1002/osp4.390The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesityMinyi Lee0Brianna N. Lauren1Tiannan Zhan2Jin Choi3Matthew Klebanoff4Barham Abu Dayyeh5Elsie M. Taveras6Kathleen Corey7Lee Kaplan8Chin Hur9Gastroenterology Division Massachusetts General Hospital Boston MassachusettsDepartment of General Medicine Columbia University Irving Medical Center New York New YorkGastroenterology Division Massachusetts General Hospital Boston MassachusettsDepartment of General Medicine Columbia University Irving Medical Center New York New YorkGastroenterology Division Massachusetts General Hospital Boston MassachusettsDivision of Gastroenterology and Hepatology Mayo Clinic Rochester MinnesotaDepartment of Pediatrics Massachusetts General Hospital Boston MassachusettsGastroenterology Division Massachusetts General Hospital Boston MassachusettsGastroenterology Division Massachusetts General Hospital Boston MassachusettsDepartment of General Medicine Columbia University Irving Medical Center New York New YorkSummary 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.https://doi.org/10.1002/osp4.390cost‐effectiveness analysisobesitypharmacotherapyweight loss |
| spellingShingle | Minyi Lee Brianna N. Lauren Tiannan Zhan Jin Choi Matthew Klebanoff Barham Abu Dayyeh Elsie M. Taveras Kathleen Corey Lee Kaplan Chin Hur The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity Obesity Science & Practice cost‐effectiveness analysis obesity pharmacotherapy weight loss |
| title | The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity |
| title_full | The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity |
| title_fullStr | The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity |
| title_full_unstemmed | The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity |
| title_short | The cost‐effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity |
| title_sort | cost effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity |
| topic | cost‐effectiveness analysis obesity pharmacotherapy weight loss |
| url | https://doi.org/10.1002/osp4.390 |
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