GLP-1 cost-effectiveness improves: 5 report notes 

A new analysis from the Institute for Clinical and Economic Review has found that blockbuster GLP-1 drugs from Novo Nordisk and Eli Lilly offer substantial health benefits and are a cost-effective option to treat obesity. 

The findings mark a shift from ICER’s last assessment on GLP-1s in 2022, which concluded the drugs were not cost-effective compared to lifestyle changes alone. The updated conclusion comes as more evidence supports the drugs’ health benefits beyond weight loss.

Four more notes:

1. The report evaluated three formulations: injectable semaglutide, the active ingredient in Novo Nordisk’s Ozempic and Wegovy; oral semaglutide, also from Novo Nordisk and under FDA review; and injectable tirzepatide, sold by Eli Lilly as Zepbound and Mounjaro. All were assessed at their maximum doses for weight loss in adults with obesity or overweight and at least one related comorbidity. The review excluded people with Type 2 diabetes.

2. The drugs each led to meaningful weight loss, improved cardiometabolic markers and quality of life benefits, the report found.

ICER used quality-adjusted life years, or QALYs, to evaluate cost-effectiveness, and found that all three drugs met its $100,000 per QALY threshold. Tirzepatide was the most cost-effective at roughly $53,000 per QALY gained, followed by injectable semaglutide at $61,000 and oral semaglutide at $69,000.

“Because treatment with all three drugs results in substantial weight loss and improvement in metabolic risk factors, we have high certainty that all three drugs have substantial net health benefit over lifestyle modifications alone,” the report said. 
3. The report noted the drugs’ high prices continue to pose a major affordability challenge. ICER estimated that treating fewer than 1% of eligible patients would exceed its annual $800 million budget impact threshold. Employers have linked rising insurance costs to the growing use of GLP-1s, with many moving to add authorization requirements or avoid coverage for obesity altogether.

4. While they do not set policy, reports from ICER often influence how payers, employers and benefit managers approach coverage decisions and drug pricing negotiations. 

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