A cost comparison of GLP-1 receptor agonists and bariatric surgery: what is the break even point?

Bariatric surgery Cost effectiveness Diabetes GLP-1 receptor agonist Mounjaro Obesity Ozempic Roux-en-Y gastric bypass Sleeve gastrectomy Wegovy

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
16 Sep 2024
Historique:
received: 13 05 2024
accepted: 17 08 2024
medline: 17 9 2024
pubmed: 17 9 2024
entrez: 16 9 2024
Statut: aheadofprint

Résumé

With the prevalence of obesity rising in the US, medical management is of increasing importance. Two popular options for the treatment of obesity are bariatric surgery (e.g. sleeve gastrectomy and Roux-en-Y gastric bypass) and the increasingly popular GLP-1 Receptor Agonists (GLP-1 s). This study examines the initial and long-term costs of GLP-1 s compared to bariatric surgery. We compared average 2023 national retail prices for GLP-1 s to surgical cost estimates from 2015 adjusted for inflation. We then plotted the cumulative medication cost over time against the flat cost of each surgery, thus calculating "break-even points" (when medication costs equal surgery costs). The findings revealed a crucial insight, for some GLP-1 s like Saxenda and Wegovy, the high cost of ongoing use surpasses the cost of RYGB in less than a year and sleeve gastrectomy within nine months. Even the most affordable option, Byetta, becomes costlier than surgery after around 1.5 years. This highlights the importance of looking beyond the initial financial investment when considering cost-effectiveness. Additionally, while not directly assessed, this study acknowledges that GLP-1 s take time to reach full effectiveness, potentially delaying weight loss while accumulating costs. Concerns also exist about weight regain after discontinuing the medication. This study is limited by the real-world variation for individual treatment costs (e.g. insurance), a limited evaluation of long-term costs associated with either treatment modality and their co-morbidities, and the reality of patient preference providing subjective value to either modality. Overall, the study offers insights into the financial trade-offs between GLP-1 s and bariatric surgery.

Sections du résumé

BACKGROUND BACKGROUND
With the prevalence of obesity rising in the US, medical management is of increasing importance. Two popular options for the treatment of obesity are bariatric surgery (e.g. sleeve gastrectomy and Roux-en-Y gastric bypass) and the increasingly popular GLP-1 Receptor Agonists (GLP-1 s). This study examines the initial and long-term costs of GLP-1 s compared to bariatric surgery.
STUDY DESIGN METHODS
We compared average 2023 national retail prices for GLP-1 s to surgical cost estimates from 2015 adjusted for inflation. We then plotted the cumulative medication cost over time against the flat cost of each surgery, thus calculating "break-even points" (when medication costs equal surgery costs). The findings revealed a crucial insight, for some GLP-1 s like Saxenda and Wegovy, the high cost of ongoing use surpasses the cost of RYGB in less than a year and sleeve gastrectomy within nine months. Even the most affordable option, Byetta, becomes costlier than surgery after around 1.5 years.
RESULTS RESULTS
This highlights the importance of looking beyond the initial financial investment when considering cost-effectiveness. Additionally, while not directly assessed, this study acknowledges that GLP-1 s take time to reach full effectiveness, potentially delaying weight loss while accumulating costs. Concerns also exist about weight regain after discontinuing the medication.
CONCLUSION CONCLUSIONS
This study is limited by the real-world variation for individual treatment costs (e.g. insurance), a limited evaluation of long-term costs associated with either treatment modality and their co-morbidities, and the reality of patient preference providing subjective value to either modality. Overall, the study offers insights into the financial trade-offs between GLP-1 s and bariatric surgery.

Identifiants

pubmed: 39285034
doi: 10.1007/s00464-024-11191-1
pii: 10.1007/s00464-024-11191-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

Centers for disease control and prevention (2023) Obesity is a common, serious, and costly disease. Available at: https://www.cdc.gov/obesity/data/adult.html . Accessed December 10th
Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. (2014) Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. The Lancet. 384:755–65
doi: 10.1016/S0140-6736(14)60892-8
Bhaskaran K, dos-Santos-Silva I, Leon DA, Douglas IJ, Smeeth L (2018) Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK. The Lancet Diab Endocrinol. 6(12):944–53
doi: 10.1016/S2213-8587(18)30288-2
Cawley J, Biener A, Meyerhoefer C, Ding Y, Zvenyach T, Smolarz BG et al (2021) Direct medical costs of obesity in the United States and the most populous states. JMCP 27(3):354–366
doi: 10.18553/jmcp.2021.20410 pubmed: 33470881
Trogdon JG, Finkelstein EA, Hylands T, Dellea PS, Kamal-Bahl SJ (2008) Indirect costs of obesity: a review of the current literature. Obes Rev 9(5):489–500
doi: 10.1111/j.1467-789X.2008.00472.x pubmed: 18331420
Dalle Grave R, Calugi S, El Ghoch M (2013) Lifestyle modification in the management of obesity: achievements and challenges. Eat Weight Disord 18(4):339–349
doi: 10.1007/s40519-013-0049-4 pubmed: 23893662
Wadden TA, Tronieri JS, Butryn ML (2020) Lifestyle modification approaches for the treatment of obesity in adults. Am Psychol 75(2):235–251
doi: 10.1037/amp0000517 pubmed: 32052997 pmcid: 7027681
Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G et al (2013) Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ 347:f5934–f5934
doi: 10.1136/bmj.f5934 pubmed: 24149519 pmcid: 3806364
Goldberg I, Yang J, Nie L, Bates AT, Docimo S, Pryor AD et al (2019) Safety of bariatric surgery in patients older than 65 years. Surg Obes Relat Dis 15(8):1380–1387
doi: 10.1016/j.soard.2019.05.016 pubmed: 31248793
Altieri MS, Pryor A, Bates A, Docimo S, Talamini M, Spaniolas K (2018) Bariatric procedures in adolescents are safe in accredited centers. Surg Obes Relat Dis 14(9):1368–1372
doi: 10.1016/j.soard.2018.04.004 pubmed: 29980465
Brown AM, Yang J, Zhang X, Docimo S, Pryo AD, Spaniolas K (2022) Bariatric surgery lowers the risk of major cardiovascular events. Ann Surg 276(5):e417–e424
doi: 10.1097/SLA.0000000000004640 pubmed: 33214477
Goldberg I, Nie L, Yang J, Docimo S, Obici S, Talamini M et al (2021) Impact of bariatric surgery on the development of diabetic microvascular and macrovascular complications. Surg Endosc 35(7):3923–3931
doi: 10.1007/s00464-020-07848-2 pubmed: 32748271
Tsui ST, Yang J, Zhang X, Docimo S, Spaniolas K, Talamini MA et al (2020) Development of cancer after bariatric surgery. Surg Obes Relat Dis 16(10):1586–1595
doi: 10.1016/j.soard.2020.06.026 pubmed: 32737010
Alalwan AA, Friedman J, Park H, Segal R, Brumback BA, Hartzema AG (2021) US national trends in bariatric surgery: a decade of study. Surgery 170(1):13–17
doi: 10.1016/j.surg.2021.02.002 pubmed: 33714616
Abdi Beshir S, Ahmed Elnour A, Soorya A, Parveen Mohamed A, Sir Loon Goh S, Hussain N et al (2023) A narrative review of approved and emerging anti-obesity medications. Saudi Pharma J. 31(10):101757
doi: 10.1016/j.jsps.2023.101757
Atlas SJ, Kim K, Nhan E, Touchette DR, Moradi A, Agboola F et al (2023) Medications for obesity management: effectiveness and value: a summary from the institute for clinical and economic review’s new england comparative effectiveness public advisory council. JMCP 29(5):569–575
doi: 10.18553/jmcp.2023.29.5.569 pubmed: 37121254
Latif W, Lambrinos KJ, Rodriguez R (2024) Compare and contrast the glucagon-like peptide-1 receptor agonists (GLP1RAs). In: statpearls [Internet]. Treasure island (FL): StatPearls Publishing; [cited 2024 Feb 28]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK572151/
Drucker DJ, Nauck MA (2006) The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. The Lancet 368(9548):1696–1705
doi: 10.1016/S0140-6736(06)69705-5
Popoviciu MS, Păduraru L, Yahya G, Metwally K, Cavalu S (2023) Emerging role of GLP-1 agonists in obesity: a comprehensive review of randomised controlled trials. IJMS. 24(13):10449
doi: 10.3390/ijms241310449 pubmed: 37445623 pmcid: 10341852
Doyle WN, Reinhart N, Reddy NC, Diab ARF, Sujka JA, DuCoin CG, et al. (2023) Anti-obesity medication use for adolescent metabolic and bariatric surgery patients: a systematic literature review. cureus [Internet]. Dec 21 [cited 2024 Feb 28]; Available from: https://www.cureus.com/articles/182317-anti-obesity-medication-use-for-adolescent-metabolic-and-bariatric-surgery-patients-a-systematic-literature-review
Vosburg RW, El Chaar M, El Djouzi S, Docimo S, Choi D, LaMasters T et al (2022) Literature review on antiobesity medication use for metabolic and bariatric surgery patients from the american society for metabolic and bariatric surgery clinical issues committee. Surg Obes Relat Dis 18(9):1109–1119
doi: 10.1016/j.soard.2022.07.002 pubmed: 36028428
McGlone ER, Carey I, Veličković V, Chana P, Mahawar K, Batterham RL et al (2020) Bariatric surgery for patients with type 2 diabetes mellitus requiring insulin: clinical outcome and cost-effectiveness analyses. PLoS Med. 17(12):e1003228
doi: 10.1371/journal.pmed.1003228 pubmed: 33285553 pmcid: 7721482
Doumouras AG, Hong D, Lee Y, Tarride JE, Paterson JM, Anvari M (2020) Association between bariatric surgery and all-cause mortality: a population-based matched cohort study in a universal health care system. Ann Intern Med. 173(9):694–703
doi: 10.7326/M19-3925 pubmed: 32805135
Veerman JL, Barendregt JJ, Forster M, Vos T (2011) Cost-effectiveness of pharmacotherapy to reduce obesity. PLoS ONE. 6(10):e26051
doi: 10.1371/journal.pone.0026051 pubmed: 22046255 pmcid: 3203105
Brown TT, Hurley VB, Rodriguez HP, Lee J, Gupta N, Toolsie G et al (2023) Shared decision-making lowers medical expenditures and the effect is amplified in racially-ethnically concordant relationships. Med Care 61(8):528–535
doi: 10.1097/MLR.0000000000001881 pubmed: 37308806
Reinhardt UE (2006) The pricing Of U.S. hospital services: chaos behind a veil of secrecy. Health Affairs 25(1):57–69
doi: 10.1377/hlthaff.25.1.57 pubmed: 16403745
Bureau of Labor Statistics (2023) Consumer price index inflation calculator. Available at: https://data.bls.gov/cgi-bin/cpicalc.pl . Accessed November 7th
Kizy S, Jahansouz C, Downey MC, Hevelone N, Ikramuddin S, Leslie D (2017) National trends in bariatric surgery 2012–2015: demographics, procedure selection, readmissions, and cost. OBES SURG 27(11):2933–2939
doi: 10.1007/s11695-017-2719-1 pubmed: 28534189
Noparatayaporn P, Thavorncharoensap M, Chaikledkaew U, Bagepally BS, Thakkinstian A (2021) Incremental net monetary benefit of bariatric surgery: systematic review and meta-analysis of cost-effectiveness evidences. OBES SURG 31(7):3279–3290
doi: 10.1007/s11695-021-05415-9 pubmed: 33893610 pmcid: 8175295
Al-Dohayan A, Qamhiah D, Abukhalaf A, Alomar A, Almutairi F, Alsalame N et al (2021) Cost effectiveness of bariatric surgery in patients with obesity related comorbidities: a retrospective study. J Family Med Prim Care 10(12):4418
doi: 10.4103/jfmpc.jfmpc_877_21
Prasad-Reddy L, Isaacs D (2015) A clinical review of GLP-1 receptor agonists: efficacy and safety in diabetes and beyond. DIC 8(4):1–19
doi: 10.7573/dic.212283
Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K et al (2022) Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Dia Obes Metab 24(8):1553–1564
doi: 10.1111/dom.14725
Snow LL, Weinstein LS, Hannon JK, Lane DR, Ringold FG, Hansen PA et al (2004) The effect of roux-en-Y gastric bypass on prescription drug costs. Obes Surg. 14(8):1031–5
doi: 10.1381/0960892041975677 pubmed: 15479590
Klein S, Ghosh A, Cremieux PY, Eapen S, McGavock TJ (2011) Economic impact of the clinical benefits of bariatric surgery in diabetes patients with BMI ≥35 kg/m
doi: 10.1038/oby.2010.199 pubmed: 20829800
Wei D, Hsiao C, Johnston S (2018) Costs of complications in laparoscopic bariatric surgery. Value in Health 21:S253
doi: 10.1016/j.jval.2018.04.1706
Docimo S Jr, Svestka M (2017) Endoscopic evaluation and treatment of postoperative bariatric surgery complications. Surg Innov 24(6):616–624. https://doi.org/10.1177/1553350617736651 . (Epub 2017 Oct 26 PMID: 29072533)
doi: 10.1177/1553350617736651 pubmed: 29072533
Sodhi M, Rezaeianzadeh R, Kezouh A, Etminan M (2023) Risk of gastrointestinal adverse events associated with glucagon-like peptide-1 receptor agonists for weight loss. JAMA. 330(18):1795
doi: 10.1001/jama.2023.19574 pubmed: 37796527 pmcid: 10557026
Lisco G, De Tullio A, Disoteo O, Piazzolla G, Guastamacchia E, Sabbà C et al (2023) Glucagon-like peptide 1 receptor agonists and thyroid cancer: is it the time to be concerned? Endocr Connect 12(11):e230257
doi: 10.1530/EC-23-0257 pubmed: 37656509 pmcid: 10563602
Luo J, Feldman R, Rothenberger SD, Hernandez I, Gellad WF (2020) Coverage, formulary restrictions, and out-of-pocket costs for sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in the medicare part D program. JAMA Netw Open. 3(10):e2020969
doi: 10.1001/jamanetworkopen.2020.20969 pubmed: 33057641 pmcid: 7563069
Cigna Healthcare. Prior authorization policy. Available at: https://static.cigna.com/assets/chcp/pdf/coveragePolicies/cnf/cnf_360_coveragepositioncriteria_glucagon-like_peptide-1_agonists_pa.pdf . Accessed February 2nd, 2024
United healthcare. United Healthcare pharmacy clinical pharmacy programs. Available at: https://www.uhcprovider.com/content/dam/provider/docs/public/prior-auth/drugs-pharmacy/commercial/a-g/PA-Notification-Diabetes-Agents-GLP1-Receptor-Agonists.pdf . Accessed February 2nd, 2024
Blue cross blue shield blue care network of Michigan. Prior authorization and step therapy coverage criteria February 2024. Available at: https://www.bcbsm.com/content/dam/public/Consumer/Documents/help/documents-forms/pharmacy/prior-authorization-and-step-therapy-guidelines.pdf . Accessed February 2nd, 2024.
Jannah N, Hild J, Gallagher C, Dietz W (2018) Coverage for obesity prevention and treatment services: analysis of medicaid and state employee health insurance programs. Obesity 26(12):1834–1840
doi: 10.1002/oby.22307 pubmed: 30426721
Bessesen DH, Van Gaal LF (2018) Progress and challenges in anti-obesity pharmacotherapy. Lancet Diab Endocrinol 6(3):237–248
doi: 10.1016/S2213-8587(17)30236-X

Auteurs

Salvatore Docimo (S)

Division of Gastrointestinal Surgery, Tampa General Hospital, Horatio Street, Tampa, FL, 33609, USA. docimo@usf.edu.

Jay Shah (J)

Morsani College of Medicine, University of South Florida, Horatio Street, Tampa, FL, 33609, USA.

Gus Warren (G)

Morsani College of Medicine, University of South Florida, Horatio Street, Tampa, FL, 33609, USA.

Samer Ganam (S)

Morsani College of Medicine, University of South Florida, Horatio Street, Tampa, FL, 33609, USA.
Division of Gastrointestinal Surgery, Tampa General Hospital, Horatio Street, Tampa, FL, 33609, USA.

Joseph Sujka (J)

Division of Gastrointestinal Surgery, Tampa General Hospital, Horatio Street, Tampa, FL, 33609, USA.

Christopher DuCoin (C)

Division of Gastrointestinal Surgery, Tampa General Hospital, Horatio Street, Tampa, FL, 33609, USA.

Classifications MeSH