COST-EFFECTIVENESS ANALYSIS OF GLP-1 RA TO PREVENT TYPE 2 DIABETES AMONG TEENAGERS IN THE UNITED STATES
Author(s)
Satoshi Koiso, MDP, BVSc;
The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, student, Seattle, WA, USA
The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, student, Seattle, WA, USA
OBJECTIVES: To assess the clinical effectiveness, costs, and cost-effectiveness of Glucagon-like peptide-1 receptor agonist (GLP-1 RA) among a hypothetical 1,660 thousand teenagers with overweight and obesity in the United States, on weight reduction and diabetes risk reduction for combating a rise in obesity and type 2 diabetes (T2D) cases among this population.
METHODS: We developed a Markov model, in which a simulated children population transitions across health states representing body weights and diabetes statuses. The model projected 10-year outcomes of numbers of obesity, prediabetes, and diabetes at the population level, QALYs, costs, and life-years, under four different medication strategies: No intervention (Status Quo); one-year liraglutide treatment (Liraglutide); one-year orlistat treatment (Orlistat); and one-year metformin treatment (Metformin). We performed one-way and probabilistic sensitivity analyses.
RESULTS: Over the 10-year simulation, the number of obesity, prediabetes, and diabetes would be the lowest, and the QALYs would be the highest in Liraglutide (21,000 fewer individuals with overweight and obesity, 5,000 fewer prediabetes cases, 6,000 fewer diabetes cases, and 46,000 higher QALYs compared with Status Quo). Metformin would be the most cost-effective at an ICER of 26,000USD/QALY from a healthcare perspective and of 58,000USD/QALY from a societal perspective. When the effectiveness of metformin is high, the ICER could be reduced to 10,000USD/QALY. Probabilistic sensitivity analyses also suggest that Metformin would be likely to be the most cost-effective when willingness to pay is above 23,000USD/QALY from the healthcare perspective.
CONCLUSIONS: Liraglutide would most effectively reduce the number of obesity, prediabetes, and diabetes and achieve the highest QALYs, although, under the current price range, this medication would not be cost-effective. With its cost-effectiveness, Metformin would be the practical option to expand healthcare insurance to cover obesity treatment among teenagers.
METHODS: We developed a Markov model, in which a simulated children population transitions across health states representing body weights and diabetes statuses. The model projected 10-year outcomes of numbers of obesity, prediabetes, and diabetes at the population level, QALYs, costs, and life-years, under four different medication strategies: No intervention (Status Quo); one-year liraglutide treatment (Liraglutide); one-year orlistat treatment (Orlistat); and one-year metformin treatment (Metformin). We performed one-way and probabilistic sensitivity analyses.
RESULTS: Over the 10-year simulation, the number of obesity, prediabetes, and diabetes would be the lowest, and the QALYs would be the highest in Liraglutide (21,000 fewer individuals with overweight and obesity, 5,000 fewer prediabetes cases, 6,000 fewer diabetes cases, and 46,000 higher QALYs compared with Status Quo). Metformin would be the most cost-effective at an ICER of 26,000USD/QALY from a healthcare perspective and of 58,000USD/QALY from a societal perspective. When the effectiveness of metformin is high, the ICER could be reduced to 10,000USD/QALY. Probabilistic sensitivity analyses also suggest that Metformin would be likely to be the most cost-effective when willingness to pay is above 23,000USD/QALY from the healthcare perspective.
CONCLUSIONS: Liraglutide would most effectively reduce the number of obesity, prediabetes, and diabetes and achieve the highest QALYs, although, under the current price range, this medication would not be cost-effective. With its cost-effectiveness, Metformin would be the practical option to expand healthcare insurance to cover obesity treatment among teenagers.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE329
Topic
Economic Evaluation
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Pediatrics