Pennington, B. orcid.org/0000-0002-1002-022X, Cummins, E. orcid.org/0009-0009-1803-4456, Chandler, A. et al. (1 more author) (2025) Challenges in modelling the cost effectiveness of pharmacotherapies for obesity. PharmacoEconomics. pp. 1171-1178. ISSN: 1170-7690
Abstract
The cost effectiveness of pharmacotherapies for obesity (such as semaglutide, tirzepatide, liraglutide, and newer agents) is increasingly being appraised by health technology assessment (HTA) bodies. Modelling is required to extrapolate weight change observed over relatively short clinical trial durations to long-term weight loss and associated cardio-metabolic outcomes and costs. Extrapolation is a common issue in HTA, but there is a unique challenge for anti-obesity drugs because of the number of interacting uncertainties. This is a particular concern given the substantial eligible population sizes and associated high financial decision risk of providing lifetime treatment. We describe four key challenges in modelling pharmacotherapies for obesity: (1) modelling long-term body mass index (BMI) trajectories with and without obesity pharmacotherapy, (2) modelling time on treatment, (3) using risk equations to link changes in BMI to clinical outcomes, and (4) modelling clinical outcomes not (solely) related to BMI changes. We discuss each of these challenges and the impact they have had in global HTA appraisals for pharmacotherapies. We speculate how these challenges relating to short-term clinical trials could be overcome to more robustly predict long-term outcomes and the role that observational data may play. As clinical trial and real-world evidence for technologies for obesity evolves, analysts and decision-makers need to determine which evidence sources are most appropriate and how they should be combined.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2025. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
Keywords: | Economics; Biomedical and Clinical Sciences; Applied Economics; Clinical Research; Comparative Effectiveness Research; Cost Effectiveness Research; Childhood Obesity; Clinical Trials and Supportive Activities; Nutrition; Pediatric; Obesity; Prevention; Biological and endogenous factors; Pharmaceuticals; Oral and gastrointestinal; Cancer; Stroke; Metabolic and endocrine; Cardiovascular |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 23 Sep 2025 14:37 |
Last Modified: | 23 Sep 2025 14:37 |
Status: | Published |
Publisher: | Springer Science and Business Media LLC |
Refereed: | Yes |
Identification Number: | 10.1007/s40273-025-01520-0 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:232102 |