Bariatric surgery more cost-effective than GLP-1s in long term
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Key takeaways:
- For patients with obesity, bariatric surgery was more cost-effective than GLP-1 receptor agonists.
- The biggest gains in quality-adjusted life-years were for patients who had both treatments.
At current prices, bariatric surgery was more cost-effective than GLP-1 receptor agonists for treatment of obesity, researchers reported at the American College of Surgeons Clinical Congress.
“GLP-1 receptor agonists are lifelong medications for obesity management that are not always covered by insurance and can cost some people $800 to $1,200 per month out-of-pocket,” Joseph Sanchez, MD, a general surgery resident at Northwestern Medicine, who presented the findings, said in a press release. “But we didn’t know how these medications compared in cost-effectiveness with the gold-standard obesity management option, bariatric surgery.”
Sanchez and colleagues developed Markov models of wholesale costs for three interventions: bariatric surgery — sleeve gastrectomy or Roux-en-Y gastric bypass — GLP-1 receptor agonists — liraglutide (Saxenda, Novo Nordisk) or semaglutide (Wegovy, Novo Nordisk) — and bariatric surgery and GLP-1 receptor agonists combined.
“As evidence of health benefits of GLP-1 receptor agonists continues to come out, insurance companies will have to decide whether they will cover these medications and in which case scenarios,” Anne Stey, MD, FACS, assistant professor of surgery at Northwestern University Feinberg School of Medicine, said in the release. “Understanding if and how these different obesity management options are cost-effective is critical to ensure as many people have access to these medications as possible.”
The researchers abstracted associated cost and health state utility data from existing U.S. literature.
Sanchez and colleagues found that the cost of GLP-1 receptor agonists averaged $11,628 per year, whereas the cost of bariatric surgery was estimated at $18,581.
Compared with GLP-1 receptor agonists alone, bariatric surgery conferred an incremental increase of 2.3 quality-adjusted life-years and was economically dominant with an incremental cost-effectiveness ratio (ICER) of –$9,094, according to the researchers.
Compared with bariatric surgery alone, bariatric surgery plus GLP-1 receptor agonists conferred an incremental increase of 5.3 QALYs and was cost-effective (ICER, +$7,239), Sanchez and colleagues found.
In a sensitivity analysis, the researchers determined that bariatric surgery was cost-effective compared with GLP-1 receptor agonists regardless of the adjusted cost of the drugs.
“Undergoing bariatric surgery is more cost-effective in the long run than maintaining these medications for the remainder of an individual’s life,” Sanchez said in the release. “The critical role for these medications from a cost-effectiveness perspective is to use these medications to address weight regained after bariatric surgery.”
Sanchez said in the release that the results could change if the prices for GLP-1 receptor agonists declined or if new medications came along that were equally effective but cost less, but that would require a reduced cost of almost 75%.
Reference:
- Bariatric surgery is more cost effective than newer weight loss drugs alone. https://www.eurekalert.org/news-releases/1061396. Published Oct. 18, 2024. Accessed Oct. 18, 2024.
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Sanchez J, et al. Bariatric/Foregut II. Presented at: American College of Surgeons Clinical Congress; Oct. 19-22, 2024; San Francisco.
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