Cost-Effectiveness of Tirzepatide Versus Liraglutide, Both Adjunct to Diet and Exercise, for Patients with Obesity or Overweight: A UK Perspective

IF 4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2025-08-11 DOI:10.1007/s12325-025-03288-3

Matthew Capehorn, Erin Johansson, Alun Davies, Jerome Evans, Fiona Godbeer, Naomi van Hest, Georgina Cotterill, Keith Tolley

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Abstract

Introduction

This study estimated the cost-effectiveness from a UK healthcare system perspective of tirzepatide (5 mg, 10 mg, 15 mg) compared to liraglutide (3 mg) both adjunct to a reduced-calorie diet and increased physical activity in patients with a body mass index (BMI) ≥ 30 kg/m² (obesity), or with a BMI ≥ 27 to < 30 kg/m² (overweight) + ≥ 1 obesity-related complication (‘trial population’). A subgroup analysis was performed in liraglutide’s National Institute of Health and Care Excellence (NICE) recommended population (patients with a BMI of ≥ 35 kg/m² with non-diabetic hyperglycaemia and a high risk of cardiovascular disease [CVD]).

Methods

A lifetime simulation model evaluated the costs and long-term clinical outcomes of each treatment. The base-case population was aligned to the population from the SURMOUNT-1 trial. The subgroup analysis included a 2-year stopping rule for liraglutide to reflect the NICE reimbursement criteria. Treatment efficacy was informed by a network meta-analysis. Patients were at risk of developing obesity-related complications such as diabetes and cardiovascular complications, calculated using published risk equations applied to modelled changes in risk factors. Incremental cost-effectiveness ratios (ICERs; cost/quality-adjusted life year [QALY]) were calculated.

Results

In the trial population, all doses of tirzepatide were dominant to liraglutide, with estimated cost savings and QALY gains. In liraglutide’s UK recommended population the estimated ICERs for tirzepatide vs liraglutide were £5401–7864/QALY gained across doses; the change in results is primarily due to the 2-year stopping rule for liraglutide in this population. In both populations, all doses of tirzepatide demonstrated reductions in at least five of seven complications compared to liraglutide, most notably for knee replacements (29–46% reduction) and diabetes (25–48% reduction).

Conclusion

On the basis of this simulation model, at the UK willingness-to-pay threshold (£20,000/QALY gained), tirzepatide is a cost-effective treatment compared to liraglutide for overweight and obesity, in both the full license SURMOUNT-1 trial population and in liraglutide’s specific NICE reimbursed population.

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替西帕肽与利拉鲁肽的成本-效果，同时辅助饮食和运动，对肥胖或超重患者：英国视角

本研究从英国医疗保健系统的角度估计了替西帕肽（5mg, 10mg, 15mg）与利拉鲁肽（3mg）的成本效益，在体重指数(BMI)≥30kg /m2（肥胖）或BMI≥27至2（超重）+≥1肥胖相关并发症（“试验人群”）的患者中，替西帕肽（5mg, 10mg, 15mg）辅助低热量饮食和增加体力活动（3 mg）。在利拉鲁肽国家健康与护理卓越研究所（NICE）推荐的人群（BMI≥35 kg/m2，伴有非糖尿病性高血糖和心血管疾病[CVD]高风险的患者）中进行亚组分析。方法：终身模拟模型评估每种治疗的成本和长期临床结果。基础病例人群与来自SURMOUNT-1试验的人群一致。亚组分析包括利拉鲁肽2年停药规则，以反映NICE报销标准。通过网络荟萃分析得知治疗效果。患者有发生肥胖相关并发症的风险，如糖尿病和心血管并发症，使用已发表的风险方程计算，应用于风险因素的模拟变化。增量成本效益比；计算成本/质量调整生命年（QALY）。结果：在试验人群中，所有剂量的替西帕肽均优于利拉鲁肽，估计可节省成本并获得QALY收益。在利拉鲁肽的英国推荐人群中，各剂量替西帕肽与利拉鲁肽的ICERs估计为5401-7864英镑/QALY；结果的变化主要是由于利拉鲁肽在该人群中的2年停药规则。在这两个人群中，与利拉鲁肽相比，所有剂量的替西帕肽在7种并发症中至少减少了5种，最显著的是膝关节置换术（减少29-46%）和糖尿病（减少25-48%）。结论：在该模拟模型的基础上，在英国的支付意愿阈值（£20,000/QALY获得）下，在完全许可的SURMOUNT-1试验人群和利拉鲁肽的特定NICE报销人群中，与利拉鲁肽相比，替西帕肽是一种具有成本效益的治疗超重和肥胖的药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.