Modeling potential cost-effectiveness of tirzepatide versus lifestyle modification for patients with overweight and obesity

Abstract

Objective: Our objective was to model the potential cost-effectiveness of tirzepatide as an alternative to lifestyle modification (LSM) for the management of obesity and overweight.

Methods: An individual-level discrete event simulation was implemented in Microsoft Excel linking short-term outcomes from the SURMOUNT-1 trial to key obesity-related complications to estimate costs and health benefits of tirzepatide (5-mg, 10-mg, or 15-mg doses) and LSM over a lifetime time horizon. Treatment-related changes in cardiometabolic factors were modeled using data from SURMOUNT-1; the relationship between patient status and risk of obesity complications was obtained from published literature. Modeled complications included cardiovascular events, onset of type 2 diabetes, cancer, osteoarthritis, and sleep apnea. The model simulated 1000 adult patients with overweight or obesity over their lifetimes, applying a 3% annual discount rate to cost and health outcomes. Only direct medical costs were considered.

Results: Tirzepatide 5, 10, and 15 mg provided 0.54, 0.55, and 0.61 additional quality-adjusted life years (QALYs) and additional costs of $79,288, $70,453, and $75,839 versus LSM, yielding incremental cost-effectiveness ratios of $146,331, $127,644, and $125,053 per QALY gained, respectively.

Conclusions: The model predicted that all doses of tirzepatide represent cost-effective alternatives to LSM for management of overweight and obesity at a willingness-to-pay threshold of $150,000 per QALY.

FIGURE 1

Model diagram. CV, cardiovascular; CVD, cardiovascular disease; FPG, fasting plasma glucose; HDL, high‐density lipoprotein; MI, myocardial infarction; SBP, systolic blood pressure; T2D, type 2 diabetes. [Color figure can be viewed at wileyonlinelibrary.com]

FIGURE 2

Diagram of BMI trajectory over time. [Color figure can be viewed at wileyonlinelibrary.com]

FIGURE 3

DSA tornado diagram. DSA, deterministic sensitivity analysis; CV, cardiovascular; FPG, fasting plasma glucose; HDL, high‐density lipoprotein; ICER, incremental cost‐effectiveness ratios; TZP, tirzepatide. [Color figure can be viewed at wileyonlinelibrary.com]