Abstract
BACKGROUND: Obesity imposes a heavy burden on healthcare systems and society. Despite various treatment options, choosing cost-effective pharmacological interventions remains a key concern for health policymakers. This study systematically reviews economic evaluations of antiobesity drugs, comparing their costs and outcomes with those of lifestyle interventions. METHODS: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four databases (PubMed, Scopus, Web of Science, and Embase) were searched for full economic evaluations of FDA-approved antiobesity drugs, including semaglutide, liraglutide, tirzepatide, phentermine-topiramate, and orlistat. Inclusion criteria required studies to report cost-effectiveness, cost-utility, or cost-benefit outcomes. Data on incremental cost-effectiveness ratios (ICERs), quality-adjusted life years (QALY), or disability-adjusted life years (DALY) were extracted and adjusted to 2024 USD using PPP. Study quality was assessed using CHEERS 2022. RESULTS: Fifteen studies met the inclusion criteria. Most used Markov models and cost-effectiveness analyses. The review of articles showed that 60% of the articles were conducted in the United States of America, 33.33% of the articles in Europe, and 6.66% of the articles in Australia. Among the reviewed studies, semaglutide was found to be the most cost-effective and clinically effective drug in most scenarios. Phentermine-topiramate showed acceptable cost-effectiveness, particularly in low-resource settings. Orlistat and naltrexone-bupropion were also considered affordable options, though with lower effectiveness. Tirzepatide, despite its high efficacy, demonstrated a higher ICER, making its cost-effectiveness context-dependent. CONCLUSIONS: These findings highlight the importance of integrating cost-effective pharmacological treatments into obesity management strategies. Semaglutide appears to be a highly effective and economically favorable option, while phentermine-topiramate and orlistat offer practical alternatives in resource-limited settings. Economic evaluations can inform policy decisions and optimize healthcare resource allocation in combating obesity.