Hormonal
Semaglutide 2.4 mg is the most cost-effective weight-management pharmacotherapy in Canada compared to standard of care (diet and exercise) and other approved drugs, primarily due to its superior ability to delay or prevent type 2 diabetes, sleep apnea, and cardiovascular events.
For adults in Canada with obesity (BMI ≥30 or ≥27 with comorbidities), Semaglutide 2.4 mg is currently the most cost-effective pharmacological treatment compared to diet/exercise alone or other drugs like Orlistat. It works by acting as a GLP-1 receptor agonist to promote weight loss and improve metabolic health. While it requires weekly injections and has a higher upfront cost, it significantly reduces the long-term risk of type 2 diabetes, cardiovascular events, and sleep apnea, making it a superior value for money in the Canadian healthcare system.
From a societal perspective, at a willingness-to-pay (WTP) threshold of CAD 50 000 per QALY, semaglutide 2.4 mg was the most cost-effective treatment, at an incremental cost-utility ratio (ICUR) of CAD 31 243 and CAD 29 014 per QALY gained versus the next best alternative, i.e., orlistat, and SoC, respectively.
Why this rating
Based on a validated Markov model using data from high-quality RCTs (STEP 1, 2, 5) and network meta-analyses, though it relies on modeling of hard endpoints rather than direct long-term trial data for all outcomes.
Source
Cost-effectiveness of weight-management pharmacotherapies in Canada: a societal perspective
Anamaria‐Vera Olivieri et al. · International Journal of Obesity · 2024
DOI 10.1038/s41366-024-01467-w
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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