The battle against obesity often pits lifestyle modifications and medication against more invasive procedures. However, a recently published study shifts the spotlight onto a critical question: Which is the better investment for weight loss, the drug semaglutide or the minimally invasive procedure known as endoscopic sleeve gastroplasty (ESG)?

Researchers Muhammad Haseeb, MD, Jagpreet Chhatwal, PhD, and their colleagues sought to answer this question. By employing a Markov cohort model, the study, conducted between September 2022 and May 2023, compared the two interventions over a five-year period in patients with class II obesity.

Cost-Effective Analysis Reveals ESG Outperforms Semaglutide

The investigation involved analyzing the costs, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER) for both treatments, with a specific focus on their affordability from a healthcare system perspective. ICU, adverse events, quality of life, and weight loss were all factors in this comprehensive study.

The Findings

What emerged was a compelling case for ESG over semaglutide. ESG not only provided greater weight loss (with patients having a lower average BMI after 5 years) but also represented a more cost-effective option. For semaglutide to be considered a competitive alternative on a cost basis, its annual cost would need to be slashed considerably.

Practical Implications

As society continues to grapple with the high prevalence of obesity and its related healthcare costs, findings like these are invaluable. They can help healthcare providers, payers, and policymakers make informed decisions about where to allocate resources effectively.

Ongoing Analysis for Long-Term Cost-Effectiveness

While this study's findings are notable, longer-term data and adjustments to the prices of medications like semaglutide could impact future assessments. However, for the moment, ESG stands as a more economical choice for treating class II obesity.

Read more about this study published in JAMA Network Open, freely accessible under the CC-BY License at JAMA Network Open.

It's important to note: This article was built with the help of Buoy Health.

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Jeff Caba, DHSc, PA-C.

Jeff brings to Buoy over 20 years of clinical experience as a physician assistant in urgent care and internal medicine. He also has extensive experience in healthcare administration, most recently as developer and director of an urgent care center. While completing his doctorate in Health Sciences at A.T. Still University, Jeff studied population health, healthcare systems, and evidence-based medi...

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References

Ryan, D. H., Lingvay, I., Deanfield, J., Kahn, S. E., Barros, E., Burguera, B., Colhoun, H. M., Cercato, C., Dicker, D., Horn, D. B., Hovingh, G. K., Jeppesen, O. K., Kokkinos, A., Lincoff, A. M., Meyhöfer, S. M., Oral, T. K., Plutzky, J., van Beek, A. P., Wilding, J. P. H., & Kushner, R. F. (2024). Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial. Nature Medicine. https://doi.org/10.1038/s41591-024-02996-7