GLP-1 receptor agonists for treating obesity without diabetes: A systematic review and meta-analysis of economic evaluations.

AIM: To pool the incremental net benefits (INBs) of using glucagon-like peptide-1 receptor agonists (GLP-1RAs) for treating obesity without diabetes. MATERIALS AND METHODS: PubMed, Embase, EconLit, CEA Registry, ProQuest Dissertation and Theses Global were searched from inception to April 2024. Cost-effectiveness studies were included if they reported economic outcomes of any GLP-1RAs in the treatment of obesity without diabetes for a minimum time horizon of 5 years. Details of the study characteristics, economic model inputs, costs, and outcomes were extracted. Monetary units were converted to 2023 US dollars. INBs with 95% confidence interval (CI) were pooled using a random-effects model. Statistical heterogeneity between studies was assessed using the I statistic. The outcome was INB, calculated by multiplying the willingness-to-pay threshold by the difference in effectiveness between two interventions, then subtracting the difference in costs, with a positive INB indicating cost-effectiveness. RESULTS: Of 634 studies identified, 9 from high-income countries (HICs) with 23 comparisons were included. The pooled INB demonstrated that semaglutide and liraglutide were not cost-effective compared to no intervention (-$3659 [95% CI, -$74 379 to $67 062] and -$32 032 [95% CI, -$101 534 to $37 488], respectively) and lifestyle interventions (-$84 060 [95% CI, -$152 645 to -$15 475] and -$70 563 [95% CI, -$106 520 to -$34 605], respectively). CONCLUSIONS: GLP-1RAs are generally not cost-effective for obesity treatment in patients without diabetes in HICs from a healthcare/payer perspective. However, they may be cost-effective in subgroups evaluated over longer time horizons. Most included studies focused on weight-related outcomes, potentially underestimating the broader economic value of GLP-1RAs. This pooled economic evidence may inform the decision-making process.