Hormonal
GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide) induce weight loss by delaying gastric emptying and increasing satiety, but long-term cost-effectiveness modeling is hindered by uncertainty regarding sustained BMI trajectories and weight regain upon cessation.
GLP-1 medications like semaglutide and tirzepatide work by slowing digestion and reducing hunger, leading to significant weight loss. However, these drugs are not a one-time cure. Stopping treatment typically leads to weight regain, suggesting that obesity management with these agents is likely a long-term commitment. Cost-effectiveness models struggle to predict long-term outcomes because clinical trials are short, making it difficult to know if the weight loss will be sustained indefinitely.
All weight loss pharmacotherapies reduce food intake and delay gastric emptying, which leads to the sensation of satiety... When patients are to take pharmacotherapies as a long-term treatment, better evidence on their long-term effectiveness is required... it is generally accepted that, on average across a cohort of people taking anti-obesity pharmacotherapies, BMI will increase when treatment is stopped
Why this rating
Based on a systematic review of multiple Health Technology Assessment (HTA) appraisals (NICE, ICER, TLV, ZIN) and clinical trial data (STEP-1, STEP-4).
Source
Challenges in Modelling the Cost Effectiveness of Pharmacotherapies for Obesity
Becky Pennington et al. · PharmacoEconomics · 2025
DOI 10.1007/s40273-025-01520-0
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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