RETURN ON INVESTMENT OF GLP-1/GIP THERAPY FOR OBESITY IN BULGARIA
Author(s)
Hristo Krastev, MA, Adriana Dacheva, MA, PhD, Georgi Svetoslavov Slavchev, PhD, Anita Hristova, MA, Veneta Todorova, PhD, Slaveyko Djambazov, MBA, PhD.
HTA Ltd, Sofia, Bulgaria.
HTA Ltd, Sofia, Bulgaria.
OBJECTIVES: Obesity is a chronic, relapsing, and multifactorial neurobehavioral disease associated with substantial clinical, social, and economic burden. In Bulgaria, obesity contributes to approximately 67,724 disability-adjusted life years (DALYs) lost annually, reflecting its impact on population health, quality of life, healthcare resource use, and productivity. This study aimed to estimate the return on investment (ROI) of pharmacological treatment with GLP-1 and GLP-1/GIP receptor agonists in Bulgaria among patients initiating therapy in 2025.
METHODS: The analysis was based on IQVIA data and was conducted from the perspectives of society and the National Health Insurance Fund (NHIF). Treatment costs were assumed to be paid out of pocket by patients. Benefits were measured through avoided NHIF costs due to prevented obesity-related complications over five years and added gross domestic product (GDP) contribution resulting from lifetime quality-adjusted life years (QALYs) gained.
RESULTS: Total drug therapy costs for the treated cohort were estimated at €34,265,623. Treatment generated health gains of +0.22 to +0.55 QALYs per patient compared with no pharmacological treatment. Among employed patients, this corresponded to 1,729 QALYs gained, monetized through GDP contribution at €35,721 per QALY, resulting in an added GDP contribution of €62,139,638 over the lifetime horizon. From the NHIF perspective, treatment was projected to prevent 733.49 obesity-related complications over five years, including 351.14 cases of type 2 diabetes, 276.17 cases of sleep apnea, 73.05 knee replacement procedures, 14.68 myocardial infarctions, 11.78 cases of unstable angina pectoris, and 6.67 strokes, generating €858,629 in healthcare cost savings. Total monetary benefits reached €62,998,266. The overall ROI was 84%, meaning that every €1 invested generated €1.84 in total monetary benefits.
CONCLUSIONS: GLP-1/GIP therapy for obesity was associated with substantial clinical, economic, and societal value in Bulgaria. By preventing obesity-related complications and generating productivity-related economic gains, pharmacological obesity treatment may support improved population health and broader economic value.
METHODS: The analysis was based on IQVIA data and was conducted from the perspectives of society and the National Health Insurance Fund (NHIF). Treatment costs were assumed to be paid out of pocket by patients. Benefits were measured through avoided NHIF costs due to prevented obesity-related complications over five years and added gross domestic product (GDP) contribution resulting from lifetime quality-adjusted life years (QALYs) gained.
RESULTS: Total drug therapy costs for the treated cohort were estimated at €34,265,623. Treatment generated health gains of +0.22 to +0.55 QALYs per patient compared with no pharmacological treatment. Among employed patients, this corresponded to 1,729 QALYs gained, monetized through GDP contribution at €35,721 per QALY, resulting in an added GDP contribution of €62,139,638 over the lifetime horizon. From the NHIF perspective, treatment was projected to prevent 733.49 obesity-related complications over five years, including 351.14 cases of type 2 diabetes, 276.17 cases of sleep apnea, 73.05 knee replacement procedures, 14.68 myocardial infarctions, 11.78 cases of unstable angina pectoris, and 6.67 strokes, generating €858,629 in healthcare cost savings. Total monetary benefits reached €62,998,266. The overall ROI was 84%, meaning that every €1 invested generated €1.84 in total monetary benefits.
CONCLUSIONS: GLP-1/GIP therapy for obesity was associated with substantial clinical, economic, and societal value in Bulgaria. By preventing obesity-related complications and generating productivity-related economic gains, pharmacological obesity treatment may support improved population health and broader economic value.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE477
Topic
Economic Evaluation, Epidemiology & Public Health, Health Technology Assessment
Topic Subcategory
Novel & Social Elements of Value
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)