Interventions of Interest:
- subcutaneous semaglutide (Wegovy, Novo Nordisk)
- liraglutide (Saxenda, Novo Nordisk)
- phentermine/topiramate (Qsymia, Vivus Pharmaceuticals)
- naltrexone/bupropion (Contrave, Currax Pharma)
The independent appraisal committee voted that evidence is adequate to demonstrate that semaglutide provides a net health benefit compared to lifestyle modification alone; however, at current pricing, semaglutide represents “low” long-term value for money. Semaglutide would only achieve common thresholds for cost-effectiveness if priced between $7,500 – $9,800 per year after rebates. Payers establishing step therapy with less expensive or off-label medications should allow individuals to choose from multiple options and permit combination therapy.
ICER’s Chief Medical Officer, David Rind, MD:
“The vast majority of people with obesity cannot achieve sustained weight loss through diet and exercise alone. As such, obesity, and its resulting physical health, mental health, and social burdens is not a choice or failing, but a medical condition. The development of safe and effective medications for the treatment of obesity has long been a goal of medical research that now appears to be coming to fruition. With a condition affecting more than 40% of adults in the US, the focus should be on assuring that these medications are priced in alignment with their benefits so that they are accessible and affordable across US society.”