COST-EFFECTIVENESS OF GLUCAGON-LIKE PEPTIDE-1 VERSUS BARIATRIC SURGERY IN THE MANAGEMENT OF OBESITY: A SYSTEMATIC LITERATURE REVIEW
Author(s)
Ziyad H. Almatruk, PharmD, M.S1, Patrick Sullivan, PhD2;
1Nova Southeastern University College of Pharmacy, Department of Sociobehavioral and Administrative Pharmacy, Plantation, FL, USA, 2Nova Southeastern University College of Pharmacy, Ave Maria, FL, USA
1Nova Southeastern University College of Pharmacy, Department of Sociobehavioral and Administrative Pharmacy, Plantation, FL, USA, 2Nova Southeastern University College of Pharmacy, Ave Maria, FL, USA
OBJECTIVES: The aim for this review was to evaluate the current evidence on the cost-effectiveness of Glucagon-Like Peptide-1 (GLP-1) compared to bariatric surgery among adults with obesity.
METHODS: A systematic search was conducted across PubMed/MEDLINE, Embase, Scopus, and Web of Science to identify economic studies on GLP-1 treatments or bariatric surgery for treatment of obesity. We included English language articles that focused on cost-effectiveness analysis of GLP-1 and bariatric surgery including adults (≥18 years) with obesity (BMI≥30). Two independent reviewers screened articles and assessed its eligibility. Intervention, comparator, model type, time horizon, perspectives, and incremental cost-effectiveness ratios (ICERs) data were extracted.
RESULTS: Out of 272 screened records, a total of 33 articles were included. The main reasons for exclusion were lack of an economic evaluation component (n=84), observational design (n=34), irrelevant population/intervention/comparators (n=20), or non-comparative analyses. Notably, only one study directly compared GLP-1 vs bariatric surgery in a model-based economic framework. In this study Ozempic was cost effective compared to bariatric surgery at willingness-to-pay threshold (WTP) of $50,000 per QALY in United States. In general, there were numerous studies showed that GLP-1s are cost-effective compared to lifestyle modification. In addition, only two study found that bariatric surgery was cost-effective compared to lifestyle modification. Multiple countries including United States, China, United kingdom, Portugal, Greece, Egypt and Saudi Arabia were represented and results differed by jurisdictions and WTP threshold.
CONCLUSIONS: Our study indicated that there is a significant gap in the published literature regarding the cost-effectiveness of GLP-1 versus bariatric surgery for obesity treatment. There was only one study comparing GLP-1s to bariatric surgery. Future research should prioritize high-quality modeling studies to evaluate the long-term value of GLP-1 compared to surgical interventions in obesity.
METHODS: A systematic search was conducted across PubMed/MEDLINE, Embase, Scopus, and Web of Science to identify economic studies on GLP-1 treatments or bariatric surgery for treatment of obesity. We included English language articles that focused on cost-effectiveness analysis of GLP-1 and bariatric surgery including adults (≥18 years) with obesity (BMI≥30). Two independent reviewers screened articles and assessed its eligibility. Intervention, comparator, model type, time horizon, perspectives, and incremental cost-effectiveness ratios (ICERs) data were extracted.
RESULTS: Out of 272 screened records, a total of 33 articles were included. The main reasons for exclusion were lack of an economic evaluation component (n=84), observational design (n=34), irrelevant population/intervention/comparators (n=20), or non-comparative analyses. Notably, only one study directly compared GLP-1 vs bariatric surgery in a model-based economic framework. In this study Ozempic was cost effective compared to bariatric surgery at willingness-to-pay threshold (WTP) of $50,000 per QALY in United States. In general, there were numerous studies showed that GLP-1s are cost-effective compared to lifestyle modification. In addition, only two study found that bariatric surgery was cost-effective compared to lifestyle modification. Multiple countries including United States, China, United kingdom, Portugal, Greece, Egypt and Saudi Arabia were represented and results differed by jurisdictions and WTP threshold.
CONCLUSIONS: Our study indicated that there is a significant gap in the published literature regarding the cost-effectiveness of GLP-1 versus bariatric surgery for obesity treatment. There was only one study comparing GLP-1s to bariatric surgery. Future research should prioritize high-quality modeling studies to evaluate the long-term value of GLP-1 compared to surgical interventions in obesity.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE438
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Surgery