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司美格鲁肽治疗超重和肥胖的成年及青少年患者的成本效果分析:系统评价。

The cost-effectiveness analysis of semaglutide for the treatment of adult and adolescent patients with overweight and obesity: a systematic review.

机构信息

Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.

Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Eur J Clin Pharmacol. 2024 Dec;80(12):1857-1870. doi: 10.1007/s00228-024-03755-w. Epub 2024 Sep 10.

Abstract

PURPOSE

The present study aimed to systematically collect and synthesize available cost-effectiveness studies of semaglutide in patients with obesity or overweight in comparison with other interventions.

METHODS

We comprehensively searched multiple electronic databases to identify relevant literature. Studies were selected based on inclusion and exclusion criteria. The quality of studies was appraised using the "Consolidated Health Economic Evaluation Reporting Standards" (CHEERS) tool. This study is conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

RESULTS

Out of a total of 252 items, after review, 32 articles were fully reviewed, and, finally, 7 studies met inclusion and exclusion criteria. The discount rate was in the range of 1.5-3.5%. Studies included showed semaglutide offered more QALYs than anti-obesity drugs but because of higher cost, in some cases, ICER exceeds the willingness to pay threshold. Results show that semaglutide creates higher total cost compared to conventional interventions in patients with class I, II, and III obesities. Results show that in patients with class I obesity (BMI 33) lifestyle intervention (LI), endoscopic sleeve gastroplasty (ESG), Sleeve gastrectomy (SG), and semaglutide create $124,195; $126,732; $139,971; and $370,776, respectively.

CONCLUSION

The current systematic review showed that semaglutide provides more QALYs and creates more costs in comparison with phentermine-topiramate, phentermine, and naltrexone-bupropion. Semaglutide may be cost-effective with substantial cost reduction. Semaglutide appears to be cost-effective versus diet and exercise (D&E) and liraglutide but it was not cost-effective versus sleeve gastrectomy, endoscopic sleeve gastroplasty, and gastric bypass.

摘要

目的

本研究旨在系统地收集和综合比较司美格鲁肽与其他干预措施在肥胖或超重患者中的成本效益研究。

方法

我们全面检索了多个电子数据库以确定相关文献。研究的选择基于纳入和排除标准。使用“健康经济评估报告标准”(CHEERS)工具评估研究的质量。本研究按照系统评价和荟萃分析的首选报告项目(PRISMA)声明进行和报告。

结果

在总共 252 项中,经过审查,有 32 篇文章进行了全面审查,最终有 7 项研究符合纳入和排除标准。折扣率在 1.5-3.5%之间。研究表明,司美格鲁肽提供的 QALY 比抗肥胖药物多,但由于成本较高,在某些情况下,ICER 超过了支付意愿阈值。结果表明,与传统干预措施相比,司美格鲁肽在 I 类、II 类和 III 类肥胖患者中产生更高的总成本。结果表明,在 I 类肥胖患者(BMI 33)中,生活方式干预(LI)、内镜下袖状胃成形术(ESG)、袖状胃切除术(SG)和司美格鲁肽分别产生 124195 美元、126732 美元、139971 美元和 370776 美元。

结论

本系统评价显示,与安非他酮-纳曲酮、安非他酮和纳曲酮相比,司美格鲁肽提供了更多的 QALY,并产生了更多的成本。司美格鲁肽具有成本效益,且成本大幅降低。司美格鲁肽与饮食和运动(D&E)和利拉鲁肽相比具有成本效益,但与袖状胃切除术、内镜下袖状胃成形术和胃旁路术相比则不具有成本效益。

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