Objectives: Access/coverage for anti-obesity medications (AOMs) is limited compared to treatments for other chronic diseases, despite high disease burden. We aimed to assess the relative value of AOMs through analysis and comparison of cost-benefit and/or clinical benefit for covered medications across selected therapeutic areas.

Methods: Comparators included a single pharmacotherapy per therapeutic area (smoking cessation, varenicline; daytime sleepiness, modafinil; migraine, erenumab; and fibromyalgia, pregabalin) selected based on similarity to AOMs across multiple characteristics (e.g., U.S. prevalence, coverage, cost evolution, type of indication). A targeted literature review (TLR) was performed to identify sources with clinical and financial outcomes for selected therapeutic areas. Parameters extracted and evaluated included direct and indirect medical costs, cost drivers, and associated comorbidities.

Results: The TLR identified 2,956 papers. Results were screened for relevant data for extraction and analysis resulting in 89 publications. Smoking and obesity represented the highest economic burden with $300 and $260 billion in yearly direct and indirect medical costs, respectively. Weight loss resulted in a reduction of $2,586 in direct medical costs per patient per year (PPPY), which is higher than cost reductions of $930 PPPY for varenicline, $1,045 PPPY for modafinil, $468 PPPY for erenumab; pregabalin utilization showed an increase of $924 PPPY. Main drivers of cost savings were reductions in outpatient, inpatient, and emergency room costs. Obesity was associated with significantly more comorbidities (17, p<0.05) than comparators (migraine=9, smoking=8, daytime sleepiness=5, fibromyalgia=2). Smoking and obesity were associated with the costliest comorbidities of cardiovascular disease, stroke, and cancer.

Conclusions: AOMs provide high relative value compared to selected analogues. Obesity was associated with the costliest comorbidities and weight loss had the largest medical cost savings. Despite this, AOMs are not currently covered by most health plans. AOM coverage and utilization may reduce the economic burden associated with obesity.