Hu Ying, Zheng Shui-Lian, Ye Xiao-Lan, Shi Jia-Na, Zheng Xiao-Wei, Pan Han-Sheng, Zhang Yi-Wen, Yang Xiu-Li, Huang Ping
Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China.
Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, China.
Ann Transl Med. 2022 Feb;10(3):152. doi: 10.21037/atm-22-200.
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.
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.
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.
Among the 4 GLP-1RAs, Semaglutide was the most cost-effective obesity medication.
全球肥胖人群数量持续增加，肥胖相关并发症加重了各国的健康负担。因此，新型减肥药物，如胰高血糖素样肽-1受体激动剂（GLP-1RAs），正受到越来越多的关注。本研究旨在评估4种GLP-1RAs对美国成年肥胖患者减肥的成本效益。
使用决策树模型比较了接受利拉鲁肽（1.8毫克，每日一次）、司美格鲁肽（1.0毫克，每周一次）、度拉鲁肽（1.5毫克，每周一次）或艾塞那肽（10微克，每日两次）的4个GLP-1RA组和1个未治疗组。所有估计参数均来自已发表的文章。采用质量调整生命年（QALYs）、成本和增量成本效益比（ICERs）作为研究终点。我们用支付意愿（WTP）阈值分析结果，并进行确定性和概率敏感性分析。
GLP-1RAs产生了有效的减肥效果；然而，基于每QALY 195000美元的WTP阈值，与未治疗相比，并非所有GLP-1RAs都具有成本效益。在4种GLP-1RAs中，司美格鲁肽提供了一种具有成本效益的策略，ICER为每QALY 135467美元。敏感性分析表明这些结果是可靠的。
在4种GLP-1RAs中，司美格鲁肽是最具成本效益的肥胖治疗药物。
