Cost‐effectiveness analysis of four glucagon‐like peptide‐1 or glucose‐dependent insulinotropic polypeptide/glucagon‐like peptide‐1 receptor agonists for the treatment of adult patients with overweight and obesity in China

Jul 4, 2025Diabetes, obesity & metabolism

Cost-effectiveness of four diabetes-related hormone treatments for overweight and obese adults in China

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Abstract

The incremental cost-effectiveness ratios for the treatments ranged from $42,818.20 to $227,355.26 compared to lifestyle management.

Under the willingness-to-pay threshold of $37,067.75, none of the GLP-1 receptor agonists or the GIP/GLP-1RA therapies were found to be cost-effective compared to lifestyle management.
Lifestyle management emerged as the most likely cost-effective option in the probabilistic sensitivity analysis.
Semaglutide was identified as the most cost-effective treatment option in scenario analyses focusing on patients with severe obesity in first-tier cities in China.
The study utilized clinical trial data and a Markov model to assess the lifetime treatment trajectory and cost-effectiveness of various obesity treatments.

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AIMS: To evaluate the cost-effectiveness of liraglutide, semaglutide, tirzepatide, benaglutide, and lifestyle management for the treatment of obesity from the perspective of the Chinese healthcare system.

MATERIALS AND METHODS: This study gathered clinical trial data from literature reviews of each treatment strategy for patients with obesity without diabetes, and efficacy data were synthesized using network meta-analysis. The data were subsequently incorporated into an constructed Markov model to simulate the lifetime treatment trajectory of patients, with a cycle length of one year. The model integrated epidemiological data from China, clinical efficacy, treatment costs, and utilities, calculating the total treatment costs and quality-adjusted life years, followed by incremental cost-effectiveness analysis. The willingness-to-pay (WTP) threshold was set at three times the per capita gross domestic product (GDP), amounting to $37 067.75. Sensitivity analysis and scenario analysis were performed.

RESULTS: The incremental cost-effectiveness ratios compared to lifestyle management for benaglutide, liraglutide, semaglutide, tirzepatide (10 mg), and tirzepatide (15 mg) were $227 355.26, $47 994.81, $42 818.20, $72 380.49, and $89 147.19. The base-case results indicated that, under the WTP threshold, none of the four glucagon-like peptide-1 receptor agonist (GLP-1RA) or glucose-dependent insulinotropic polypeptide (GIP)/GLP-1RA therapies were cost-effective compared with lifestyle management. In the probabilistic sensitivity analysis, under the WTP threshold, lifestyle management was the most likely to be cost-effective. Scenario analysis showed that, in the severe obesity patient population and in first-tier cities in China, semaglutide is the most cost-effective treatment option.

CONCLUSIONS: GLP-1 RA or GIP/GLP-1RA are not cost-effective for obesity treatment in China currently. Nevertheless, semaglutide exhibits relatively favourable economic potential across multiple subgroups.

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Cost‐effectiveness analysis of four glucagon‐like peptide‐1 or glucose‐dependent insulinotropic polypeptide/glucagon‐like peptide‐1 receptor agonists for the treatment of adult patients with overweight and obesity in China

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