Cost-effectiveness analysis of four glucagon-like peptide-1 or glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonists for the treatment of adult patients with overweight and obesity in China.

Aims: To evaluate the cost-effectiveness of liraglutide, semaglutide, tirzepatide, benaglutide, and lifestyle management for the treatment of obesity from the perspective of the Chinese healthcare system.

Materials And Methods: This study gathered clinical trial data from literature reviews of each treatment strategy for patients with obesity without diabetes, and efficacy data were synthesized using network meta-analysis. The data were subsequently incorporated into an constructed Markov model to simulate the lifetime treatment trajectory of patients, with a cycle length of one year. The model integrated epidemiological data from China, clinical efficacy, treatment costs, and utilities, calculating the total treatment costs and quality-adjusted life years, followed by incremental cost-effectiveness analysis. The willingness-to-pay (WTP) threshold was set at three times the per capita gross domestic product (GDP), amounting to $37 067.75. Sensitivity analysis and scenario analysis were performed.

Results: The incremental cost-effectiveness ratios compared to lifestyle management for benaglutide, liraglutide, semaglutide, tirzepatide (10 mg), and tirzepatide (15 mg) were $227 355.26, $47 994.81, $42 818.20, $72 380.49, and $89 147.19. The base-case results indicated that, under the WTP threshold, none of the four glucagon-like peptide-1 receptor agonist (GLP-1RA) or glucose-dependent insulinotropic polypeptide (GIP)/GLP-1RA therapies were cost-effective compared with lifestyle management. In the probabilistic sensitivity analysis, under the WTP threshold, lifestyle management was the most likely to be cost-effective. Scenario analysis showed that, in the severe obesity patient population and in first-tier cities in China, semaglutide is the most cost-effective treatment option.

Conclusions: GLP-1 RA or GIP/GLP-1RA are not cost-effective for obesity treatment in China currently. Nevertheless, semaglutide exhibits relatively favourable economic potential across multiple subgroups.