Table 1 Base-case cost-effectiveness results (costs are 2021 CAD).
From: Cost-effectiveness of weight-management pharmacotherapies in Canada: a societal perspective
Intervention Cost* | Obesity disease cost | Total cost | Total QALY | Incr. cost | Incr. QALY | ICUR (vs. next best alternative) | ICUR vs. SoC | |
|---|---|---|---|---|---|---|---|---|
Base-case results, societal perspective including WPL | ||||||||
Diet and exercise | 0 | 208 458 | 208 458 | 18.18 | ||||
Orlistat | 1901 | 207 551 | 209 452 | 18.22 | 994 | 0.04 | 23 479 | 23 479 |
NB-32 mg | 3336 | 207 427 | 210 763 | 18.23 | Ext. dom. | Ext. dom. | Ext. dom. | 45 842 |
Liraglutide 3.0 mg | 5839 | 206 783 | 212 622 | 18.27 | Ext. dom. | Ext. dom. | Ext. dom. | 46 476 |
Semaglutide 2.4 mg | 6737 | 205 999 | 212 736 | 18.32 | 3284 | 0.11 | 31 243 | 29 014 |
Results, private payer perspective only | ||||||||
Diet and exercise | 0 | 144 916 | 144 916 | 18.18 | ||||
Orlistat | 1901 | 144 558 | 146 459 | 18.22 | 1543 | 0.04 | 36 475 | 36 475 |
NB-32 mg | 3336 | 144 516 | 147 852 | 18.23 | Ext. dom. | Ext. dom. | Ext. dom. | 58 398 |
Liraglutide 3.0 mg | 5839 | 144 271 | 150 110 | 18.27 | Ext. dom. | Ext. dom. | Ext. dom. | 57 983 |
Semaglutide 2.4 mg | 6737 | 144 028 | 150 765 | 18.32 | 4306 | 0.11 | 40 966 | 39 677 |
Results, public payer perspective only | ||||||||
Diet and exercise | 0 | 54 944 | 54 944 | 18.18 | ||||
Orlistat | 1901 | 54 531 | 56 432 | 18.22 | 1488 | 0.04 | 35 169 | 35 169 |
NB-32 mg | 3336 | 54 476 | 57 812 | 18.23 | Ext. dom. | Ext. dom. | Ext. dom. | 57 024 |
Liraglutide 3.0 mg | 5839 | 54 202 | 60 041 | 18.27 | Ext. dom. | Ext. dom. | Ext. dom. | 56 883 |
Semaglutide 2.4 mg | 6737 | 53 813 | 60 550 | 18.32 | 4118 | 0.11 | 39 180 | 38 029 |
Scenario 1, intention-to-treat analysis (no stopping rule) | ||||||||
Diet and exercise | 0 | 208 458 | 208 458 | 18.18 | ||||
Orlistat | 3592 | 206 948 | 210 540 | 18.24 | 2081 | 0.06 | 33 585 | 33 585 |
NB-32 mg | 6307 | 206 706 | 213 013 | 18.25 | Ext. dom. | Ext. dom. | Ext. dom. | 64 170 |
Liraglutide 3.0 mg | 7740 | 206 397 | 214 137 | 18.27 | Dominated | Dominated | Dominated | 60 487 |
Semaglutide 2.4 mg | 8169 | 205 934 | 214 103 | 18.33 | 3563 | 0.09 | 40 825 | 37 819 |
Scenario 2, cycle discount + trial product estimand + next-line bariatric surgery | ||||||||
Diet and exercise | 0 | 208 488 | 208 488 | 18.18 | ||||
Orlistat | 1546 | 207 732 | 209 277 | 18.21 | 789 | 0.04 | 20 744 | 20 744 |
NB-32 mg | 3336 | 207 653 | 210 989 | 18.22 | Ext. dom. | Ext. dom. | Ext. dom. | 58 146 |
Liraglutide 3.0 mg | 5868 | 206 988 | 212 855 | 18.26 | Ext. dom. | Ext. dom. | Ext. dom. | 54 742 |
Semaglutide 2.4 mg | 6798 | 206 227 | 213 025 | 18.31 | 3747 | 0.10 | 38 481 | 33 497 |
Scenario 3, comparison based on the head-to-head trial STEP 8 [74] | ||||||||
Liraglutide 3.0 mg | 5301 | 179 907 | 185 208 | 19.391 | ||||
Semaglutide 2.4 mg | 6530 | 178 407 | 184 936 | 19.479 | –271 | 0.09 | Dominant | NA |
Scenario 4, excluding weight-loss effect on complications and mortality (combined) | ||||||||
Diet and exercise | 0 | 208 482 | 208 482 | 18.16 | ||||
Orlistat | 1901 | 207 587 | 209 488 | 18.19 | 1005 | 0.03 | 35 723 | 35 723 |
NB-32 mg | 3335 | 207 462 | 210 797 | 18.19 | Ext. dom. | Ext. dom. | Ext. dom. | 78 817 |
Liraglutide 3.0 mg | 5837 | 206 830 | 212 667 | 18.21 | Ext. dom. | Ext. dom. | Ext. dom. | 81 373 |
Semaglutide 2.4 mg | 6734 | 206 041 | 212 775 | 18.24 | 3287 | 0.06 | 58 851 | 51 102 |
