COST-EFFECTIVENESS ANALYSIS OF ORFORGLIPRON AND SEMAGLUTIDE FOR THE TREATMENT OF ADULTS WITH OBESITY IN THE UNITED STATES
Author(s)
Kwame Kissi-Twum, BPharm, MS1, Minkyoung Yoo, PhD2, Joseph Mattingly II, MBA, PharmD, PhD1, Richard E. Nelson, PhD2, Nathorn Chaiyakunapruk, PharmD, PhD1;
1University of Utah College of Pharmacy, Department of Pharmacotherapy, Salt Lake City, UT, USA, 2University of Utah School of Medicine, Department of Internal Medicine, Salt Lake City, UT, USA
1University of Utah College of Pharmacy, Department of Pharmacotherapy, Salt Lake City, UT, USA, 2University of Utah School of Medicine, Department of Internal Medicine, Salt Lake City, UT, USA
OBJECTIVES: To conduct a cost-effectiveness analysis comparing oral semaglutide and orforglipron as adjuncts to lifestyle modification (LSM) versus LSM alone from a healthcare sector perspective in the US adult population with obesity.
METHODS: We used a state-transition Markov model to estimate incremental cost-effectiveness ratios (ICERs), quality-adjusted life-years (QALYs), disease-free life-years (DFLYs), and costs over a 10-year time horizon. The modeled population included non-diabetic obese adults aged 45 years or older, with baseline characteristics derived from published literature. Interventions were parameterized using efficacy data from published trials. Cost-effectiveness was assessed using the ACC/AHA willingness-to-pay (WTP) threshold of $120,000/QALY. Sensitivity and scenario analyses were conducted to assess robustness of the results.
RESULTS: In the base-case deterministic analysis, semaglutide plus LSM resulted in 0.28 additional QALYs compared with LSM alone at an incremental cost of $40,213; this yielded an ICER of $141,143/QALY. Likewise, orforglipron plus LSM yielded an ICER of $161,466/QALY with an incremental cost and QALY of $37,119 and 0.23, respectively. Compared to LSM alone, the incremental cardiometabolic DFLY for semaglutide plus LSM was 0.95, and that for orforglipron plus LSM was 0.87. In the sensitivity analyses, semaglutide plus LSM had a 31% probability of cost-effectiveness at a WTP threshold of $120,000/QALY; this increased to 76% at a threshold of $200,000/QALY. Likewise, orforglipron plus LSM had a 23% probability of cost-effectiveness at $120,000/QALY, rising to 67% at a $200,000/QALY threshold. In addition, baseline body mass index was the most influential parameter.
CONCLUSIONS: Compared to LSM alone, semaglutide plus LSM and orforglipron plus LSM were not cost-effective at the anticipated net price of $6,829 for each product, and a WTP threshold of $120,000 per QALY gained. Our findings suggest that both drugs may offer greater value in groups with a higher baseline risk; hence, policymakers and payers may consider risk-targeted coverage or value-based pricing to improve affordability.
METHODS: We used a state-transition Markov model to estimate incremental cost-effectiveness ratios (ICERs), quality-adjusted life-years (QALYs), disease-free life-years (DFLYs), and costs over a 10-year time horizon. The modeled population included non-diabetic obese adults aged 45 years or older, with baseline characteristics derived from published literature. Interventions were parameterized using efficacy data from published trials. Cost-effectiveness was assessed using the ACC/AHA willingness-to-pay (WTP) threshold of $120,000/QALY. Sensitivity and scenario analyses were conducted to assess robustness of the results.
RESULTS: In the base-case deterministic analysis, semaglutide plus LSM resulted in 0.28 additional QALYs compared with LSM alone at an incremental cost of $40,213; this yielded an ICER of $141,143/QALY. Likewise, orforglipron plus LSM yielded an ICER of $161,466/QALY with an incremental cost and QALY of $37,119 and 0.23, respectively. Compared to LSM alone, the incremental cardiometabolic DFLY for semaglutide plus LSM was 0.95, and that for orforglipron plus LSM was 0.87. In the sensitivity analyses, semaglutide plus LSM had a 31% probability of cost-effectiveness at a WTP threshold of $120,000/QALY; this increased to 76% at a threshold of $200,000/QALY. Likewise, orforglipron plus LSM had a 23% probability of cost-effectiveness at $120,000/QALY, rising to 67% at a $200,000/QALY threshold. In addition, baseline body mass index was the most influential parameter.
CONCLUSIONS: Compared to LSM alone, semaglutide plus LSM and orforglipron plus LSM were not cost-effective at the anticipated net price of $6,829 for each product, and a WTP threshold of $120,000 per QALY gained. Our findings suggest that both drugs may offer greater value in groups with a higher baseline risk; hence, policymakers and payers may consider risk-targeted coverage or value-based pricing to improve affordability.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE12
Topic
Economic Evaluation
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)