A groundbreaking economic evaluation study has shed light on the cost-effectiveness of antiobesity drugs for adolescents with severe obesity. The research found that among the four antiobesity drugs currently approved for pediatric use, phentermine-topiramate was the most cost-effective option. The study, which utilized a Markov microsimulation model, has significant implications for the treatment and reimbursement decisions for this vulnerable population.
Key Findings:
The study aimed to quantify the cost-effectiveness of various antiobesity drugs for pediatric use. Here are the key findings:
- Phentermine-Topiramate Most Cost-Effective: Phentermine-topiramate was identified as the most cost-effective treatment among the four antiobesity drugs approved for pediatric use.
- Incremental Cost-Effectiveness Ratio: The incremental cost-effectiveness ratio (ICER) for phentermine-topiramate was $93,620 per quality-adjusted life-year (QALY) gained, relative to no treatment. This ICER fell within the commonly used willingness-to-pay threshold.
- Semaglutide’s Efficacy: Semaglutide, while offering more QALYs than phentermine-topiramate, had an ICER of $1,079,480 per QALY, which exceeded the willingness-to-pay threshold.
- Other Drugs Less Effective and More Costly: Orlistat and liraglutide were found to be less effective and more costly than phentermine-topiramate and semaglutide, respectively.
- Bariatric Surgery: Sleeve gastrectomy and gastric bypass, though more effective than phentermine-topiramate, were also more costly and not considered cost-effective compared to the medication at the willingness-to-pay threshold.
Implications:
These findings have important implications for clinical and reimbursement decision-making:
- Affordable Treatment Option: Phentermine-topiramate offers a cost-effective treatment option for adolescents with severe obesity.
- Budgetary Considerations: The study suggests that lower-cost options place less strain on healthcare budgets, an important consideration for payers.
- Long-Term Efficacy: Further research is needed to understand the long-term efficacy of these drugs and how long adolescents will continue treatment.
- Safety Concerns: Safety concerns for some drugs, such as potential birth defects and thyroid cancer, should also be carefully considered in treatment decisions.
- Future Research: As more data on long-term weight loss effects from nationally representative samples become available, these findings can be updated to reassess the cost-effectiveness of these drug therapies.
The study provides valuable insights for medical professionals, policymakers, and healthcare providers as they seek to address the pressing issue of severe obesity among adolescents in the United States.
Source: JAMA Network Open Journal