OBJECTIVES: Assess the cost-utility of the glucagon-like peptide-1 agonists use in patients with obstructive sleep apnea (OSA) who are unable or unwilling to use continuous positive airway pressure (CPAP) versus no treatment in Colombia.

METHODS: A decision-tree cost-utility analysis was developed to estimate the incremental costs and Quality Adjusted Life Years (QALY) of liraglutide compared to no treatment in patients with moderate or severe OSA (<40 events/hour according to the apnea-hypopnea index AHI), unable or unwilling to use CPAP, < 50 years, with a body mass index BMI ≥ 30 and obesity duration < 5 years. Clinical endpoints were clinical improvement (mild OSA, i.e. AHI <15 events/hour), complications: stroke and acute myocardial infarction (AMI). Clinical data were based on the SCALE Sleep Apnea clinical trial, complications were estimated as population attributable fractions and costs were estimated based on the Sistema de Información de Precios de Medicamentos (SISMED) (Drugs Pricing Information System) and expressed in US Dollars. The horizon time was one year, and the perspective was the health system. Deterministic and probabilistic sensitivity analyses were implemented.

RESULTS: The clinic impact of liraglutide use versus no treatment in patients subject to the analysis was reflected in a reduction in favor of the liraglutide group, of 36.0% and 44.9% events of stroke and AMI respectively. The annual incremental costs per patient were USD884. QALYs increased by 8.7% and the incremental cost-effectiveness ratio was USD13,875/QALY.

CONCLUSIONS: Based on the assumptions of this analysis, glucagon-like peptide-1 agonists may be a cost-effective alternative for patients who are unable or unwilling to use CPAP.