Ozempic and Wegovy Are More Expensive and Less Effective Than Gastroplasty
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There’s no question that new injected medicines like Wegovy and Ozempic are helping a lot of people who are overweight or have obesity shed excess pounds. But a new study suggests that the high price tag for these drugs may mean they’re not always the most cost-effective option.
For the study, researchers did a cost-benefit analysis comparing two treatment options for people with obesity: weekly injections of semaglutide (the active ingredient in Wegovy and Ozempic) or a minimally invasive weight loss procedure known as endoscopic sleeve gastroplasty. They used mathematical models to estimate the potential costs, weight loss, and changes in quality of life for each of these options, and in the scenario of no weight loss treatment at all.
But over five years, people lost more weight and had lower medical costs with endoscopic sleeve gastroplasty than with semaglutide, the study found.
For semaglutide to be just as cost-effective as this procedure, the annual cost of the drug would need to be reduced by more than $10,000 — from $13,618 per year to $3,591, researchers calculated.
“This economic evaluation study suggests that endoscopic sleeve gastroplasty is cost-saving compared with semaglutide,” concluded the senior study author, Christopher Thompson, MD, of Brigham and Women’s Hospital in Boston, and his colleagues.
“This finding is due to the increased effectiveness and lower costs of endoscopic sleeve gastroplasty and the increased dropout rates over time with semaglutide,” the authors wrote. Thompson didn’t respond to requests for comment.
Ozempic and Wegovy both contain the same active ingredient, semaglutide, and are in a family of medicines known as GLP-1 receptor agonists that can help control blood sugar and reduce hunger.
What Is Endoscopic Sleeve Gastroplasty?
“I think semaglutide is less cost effective because it is an ongoing, monthly cost to patients, whereas a procedure like ESG has the costs of the intervention, but no ongoing monthly costs,” says Anita Courcoulas, MD, MPH, a professor and the chair of minimally invasive bariatric and general surgery at the University of Pittsburgh Medical Center.
Up to about 1 in 5 people who start taking semaglutide stop, either because of side effects or costs, the study also estimated. Because patients regain weight when they stop treatment, this also contributes to the reduced cost-effectiveness of the medication, according to the study.
Out-of-Pocket Costs for Ozempic Compared With Endoscopic Sleeve Gastroplasty
The study also focuses on overall health costs, not necessarily what patients would pay out of pocket for the procedure or the medication to aid weight loss.
At this point in time, insurance typically covers older versions of bariatric surgery that require incisions through the skin to reach the stomach, says Dr. Courcoulas, who wasn’t involved in the new study. But because both ESG and semaglutide are relatively new options for weight loss, many patients will struggle to get insurance coverage for either one of these options, Courcoulas says.
“Typically insurance coverage takes time and a good deal of long-term safety and efficacy data behind it, so I do not predict that the majority of insurers will cover the new medications or ESG in the very near future,” Courcoulas says.
“Bariatric surgery is covered by many insurers after a series of preparatory steps are completed,” Courcoulas adds. “So right now, surgery is covered more so than the less-invasive options, but once more data evolves for the newer treatment options, more coverage will likely come.”
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