Over a five-year period, medications such as Wegovy can amount to an additional $10,000 annually compared to endoscopic sleeve gastroplasty. In the long run, GLP-1 drugs like Ozempic and Wegovy are more expensive and result in less weight loss than the endoscopic sleeve gastroplasty procedure, which reduces the stomach’s size.
There’s no doubt that new injectable medications like Wegovy and Ozempic are making significant strides in helping individuals with obesity lose excess weight. However, a recent study indicates that the high cost of these drugs might limit their cost-effectiveness.
In this study, researchers conducted a cost-benefit analysis to compare two obesity treatments: weekly injections of semaglutide (the active ingredient in Wegovy and Ozempic) and a minimally invasive weight loss procedure known as endoscopic sleeve gastroplasty. The analysis employed mathematical models to estimate the costs, weight loss outcomes, and quality of life changes for each treatment, as well as a scenario where no weight loss treatment was provided.
The study, published in JAMA Network Open, found that semaglutide was more cost-effective in the first year of treatment. However, over a five-year period, endoscopic sleeve gastroplasty led to greater weight loss and lower medical costs compared to semaglutide.
To match the cost-effectiveness of endoscopic sleeve gastroplasty, the annual cost of semaglutide would need to be significantly reduced. Researchers estimated that the yearly cost of semaglutide would have to drop from $13,618 to $3,591.
“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 had written. There were requests for further comments from Thompson, but these were unanswered from his side.
Ozempic and Wegovy both contain semaglutide, an active ingredient belonging to a class of medications known as GLP-1 receptor agonists. These medicines are effective in controlling blood sugar levels and reducing hunger.
All About Endoscopic Sleeve Gastroplasty
Endoscopic sleeve gastroplasty (ESG) is a relatively new weight loss procedure that offers a less invasive alternative to traditional bariatric surgeries like gastric bypass, which involve making incisions through the skin to reduce the stomach’s size. Instead, ESG is performed endoscopically: doctors insert a flexible tube through the throat and into the stomach. Using this tube, they place sutures to create folds in the stomach tissue, which reduces its volume. This effectively limits the amount of food the stomach can hold, promoting weight loss. According to Johns Hopkins Medicine, this method minimizes the risks and recovery time associated with more invasive surgeries.
“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,” Anita Courcoulas, MD, MPH, a professor and the chair of minimally invasive bariatric and general surgery at the University of Pittsburgh Medical Center, stated.
The study estimated that nearly 1 in 5 individuals who begin taking semaglutide discontinue its use due to side effects or high costs. When patients stop the treatment, they tend to regain the weight they had lost, which further diminishes the medication’s cost-effectiveness.
Out-of-Pocket Costs for Ozempic Vs. Endoscopic Sleeve Gastroplasty
The research primarily examines the total healthcare costs associated with weight loss treatments, rather than focusing on the direct out-of-pocket expenses patients might incur for specific procedures or medications.
According to Dr. Anita Courcoulas, who did not participate in the new study, current insurance plans generally cover traditional forms of bariatric surgery, which involve making incisions in the skin to access the stomach. However, since both Endoscopic Sleeve Gastroplasty (ESG) and the weight loss drug semaglutide are newer interventions, patients often face significant challenges in securing insurance coverage for these options.
“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 shared.
“Bariatric surgery is covered by many insurers after a series of preparatory steps are completed,” Courcoulas also said. “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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