Cost Comparison of Alternative Delivery Routes for Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RA) in the English National Health Service (NHS)
Author(s)
Celia Villalba Mendez, MPharm1, Stephen Bradley, MSc1, Abi White, Post-graduate Certificate2, Andreas Freitag, MSc1.
1Health Economics, Reimbursement, and Outcomes, Roche Products Limited, Welwyn Garden City, United Kingdom, 2Future Portfolio Partner, Roche Products Limited, Welwyn Garden City, United Kingdom.
1Health Economics, Reimbursement, and Outcomes, Roche Products Limited, Welwyn Garden City, United Kingdom, 2Future Portfolio Partner, Roche Products Limited, Welwyn Garden City, United Kingdom.
OBJECTIVES: Obesity poses a significant burden on individuals, healthcare systems, and society. While clinical trials have highlighted the benefit of GLP-1RAs on supporting weight loss and improving weight-related comorbidities, access to these treatments has generally been restricted due to capacity constraints and the size of the eligible patient population. More recently, the National Institute for Health and Care Excellence (NICE) recommended tirzepatide be made available in primary care (PC), albeit through a step-wise rollout based on clinical need due to implementation challenges. The objective of this research was to assess potential cost savings to the NHS considering alternative delivery routes for GLP-1RAs.
METHODS: A simple cost-comparison of newly established PC and potential future community pharmacy delivery routes was conducted. Resource use and costs were derived from the tirzepatide NICE appraisal and tirzepatide regulatory label requirements for the PC and pharmacy routes, respectively. For the pharmacy route, an assumption was made on the expectation for a monthly review based on requirement for repeat prescription and dose monitoring. Pharmacy costs were derived from the oral contraception community pharmacy delivery model. GLP-1RA treatment costs and new service set-up costs were not considered given the focus on delivery routes, commercial pricing strategies and lack of available data.
RESULTS: Average 3-year delivery cost estimates were £1,949.49 and £900 for PC and community pharmacy routes, respectively. First-year general practitioner visits were a major cost driver for the PC route. Scenario analyses for hybrid models to address clinical risk concerns still resulted in cost savings over the PC route, though to a lesser extent.
CONCLUSIONS: Community pharmacy GLP-1RA delivery can alleviate NHS capacity constraints and significantly cut costs. These savings could then accelerate NHS access to GLP-1RAs to eligible patients. Further research is needed on the long-term impact and cost savings of wider GLP-1RA access, particularly concerning weight-related comorbidities.
METHODS: A simple cost-comparison of newly established PC and potential future community pharmacy delivery routes was conducted. Resource use and costs were derived from the tirzepatide NICE appraisal and tirzepatide regulatory label requirements for the PC and pharmacy routes, respectively. For the pharmacy route, an assumption was made on the expectation for a monthly review based on requirement for repeat prescription and dose monitoring. Pharmacy costs were derived from the oral contraception community pharmacy delivery model. GLP-1RA treatment costs and new service set-up costs were not considered given the focus on delivery routes, commercial pricing strategies and lack of available data.
RESULTS: Average 3-year delivery cost estimates were £1,949.49 and £900 for PC and community pharmacy routes, respectively. First-year general practitioner visits were a major cost driver for the PC route. Scenario analyses for hybrid models to address clinical risk concerns still resulted in cost savings over the PC route, though to a lesser extent.
CONCLUSIONS: Community pharmacy GLP-1RA delivery can alleviate NHS capacity constraints and significantly cut costs. These savings could then accelerate NHS access to GLP-1RAs to eligible patients. Further research is needed on the long-term impact and cost savings of wider GLP-1RA access, particularly concerning weight-related comorbidities.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE190
Topic
Economic Evaluation, Health Service Delivery & Process of Care
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas