Pharmacoeconomic evaluation of anti-obesity drugs for chronic weight management: a systematic review of literature

Yan Xue; Huimin Zou; Zhen Ruan; Xianwen Chen; Yunfeng Lai; Dongning Yao; Carolina Oi Lam Ung; Hao Hu

doi:10.3389/fendo.2023.1254398

Pharmacoeconomic evaluation of anti-obesity drugs for chronic weight management: a systematic review of literature

Front Endocrinol (Lausanne). 2023 Nov 6:14:1254398. doi: 10.3389/fendo.2023.1254398. eCollection 2023.

Authors

Yan Xue¹, Huimin Zou¹, Zhen Ruan¹, Xianwen Chen¹, Yunfeng Lai², Dongning Yao³, Carolina Oi Lam Ung^{1

4}, Hao Hu^{1

4}

Affiliations

¹ State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, Macao SAR, China.
² School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China.
³ School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China.
⁴ Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.

Abstract

Introduction: Pharmacological therapy is recommended as a second-line alternative to reverse obesity. Currently, five anti-obesity drugs (AODs) have been approved by the U.S. Food and Drug Administration (FDA) for chronic weight management. The aim of this paper is to investigate the pharmacoeconomic evaluation of AODs through a systematic review with a special focus on methodological considerations.

Methods: We searched the general and specific databases to identify the primary pharmacoeconomic evaluation of AODs.

Results: A total of 18 full-text articles and three conference abstracts were included in this review. Most of the economic assessments were still about Orlistat. And the observations we could make were consistent with the previous systematic review. A few studies were on the combined therapies (i.e. PHEN/TPM ER and NB ER) compared to different comparators, which could hardly lead to a generalized summary of the cost-effectiveness. Most recently, pharmacoeconomic evidence on the newest GLP 1 RA approved for the indication of obesity or obesity with at least one comorbidity emerged gradually. Modelling-based cost-utility analysis is the major type of assessment method. In the modelling studies, a manageable number of the key health states and the state transitions were structured to capture the disease progression. In particular, the principal structure of the decision model adopted in the three studies on the newly approved drug was nearly the same, which enables more in-depth comparisons and generalizations of the findings.

Conclusion: This study provided an up-to-date overview of the strengths and areas for improvement in the methodological design of the pharmacoeconomic evaluation of the licensed drugs for chronic weight management. Future modelling evaluations would benefit from a better understanding of the long-term weight loss effects of the current therapeutic options and the weight rebound process after the discontinuation of treatment.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022302648, identifier CRD42022302648.

Keywords: anti-obesity drugs; cost-effectiveness; methodology; modeling; obesity.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Anti-Obesity Agents* / therapeutic use
Comorbidity
Economics, Pharmaceutical
Humans
Obesity / drug therapy
Orlistat / therapeutic use
United States

Substances

Anti-Obesity Agents
Orlistat

Grants and funding

This research is supported by the fundings of the University of Macau (MYRG2020-00230-ICMS) and The Science and Technology Development Fund, Macao SAR (001/2023/ALC).