The Institute for Clinical and Economic Review (ICER) on Tuesday released a Draft Evidence Report assessing the comparative clinical effectiveness and value of Novo Nordisk A/S’ NVO semaglutide (Wegovy) and Eli Lilly and Co.’s LLY tirzepatide (Zepbound) for obesity management.
ICER is also assessing how these treatments affect additional obesity-related outcomes.
In a draft report, the ICER determined that the drugs are cost-effective because, when added on to lifestyle modification, provide greater clinical benefits than lifestyle modification alone, including reducing metabolic risk factors and addressing obesity-related health complications.
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The drug pricing group analyzed Novo Nordisk’s injectable semaglutide at the 2.4 mg dose, its investigational oral semaglutide 25 mg dose, and Eli Lilly’s injectable 15 mg dose of tirzepatide.
The report said that although these treatments increase intervention costs, they yield long-term savings in non-intervention costs. At current net prices, their incremental cost-effectiveness ratios were below commonly used cost-effectiveness thresholds.
“Because treatment with all three drugs results in substantial weight loss and improvement in metabolic risk factors, we have high certainty that all three drugs have substantial net health benefit over lifestyle modifications alone,” ICER reported.
The report noted Lilly’s tirzepatide a “promising but inconclusive” designation when comparing its profile against the two versions of semaglutide, while oral semaglutide was given a “comparable or worse” assessment compared with its injectable drug, highlighting lower weight loss results and an uncertain cardio risk reduction.
ICER used the estimated cost for a year of semaglutide, which was $6,829, down from $13,618 in the 2022 model, and for tirzepatide, it was $7,973.
Despite its glowing cost-effectiveness analysis, ICER flagged “serious” concerns about affordability. ICER report adds that fewer than 1% of eligible patients can be treated before the drugs cross their “budget impact threshold” of $880 million annually.
ICER solicits comments on the report until October 6 and plans to hold a virtual public meeting on its findings in November.
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