Study wrapper · #1127
Cost-Effectiveness of Access to Obesity Care and Treatments for Adolescents.
Editor's note
The striking number is not the cost-effectiveness ratio but the collapse from 57% to 3% of averted obesity cases once realistic access frictions are modelled. That gap says the binding constraint is not drug efficacy but whether adolescents reach a prescriber at all. This is a simulation built on parameter estimates and 2025 pricing, so the absolute figures will shift as prices move, and the authors note the results are sensitive to assumed efficacy and discontinuation rates.
Plain-language abstract
A health-economic model simulated 1,000 US adolescents from age 12 to 26 to compare phentermine-topiramate, semaglutide, bariatric surgery, and lifestyle modification for adolescent obesity, then tested what happens when access to primary care, specialty visits, and therapy initiation is imperfect. Assuming perfect access, phentermine-topiramate came in at about $112,000 per quality-adjusted life year versus lifestyle change, and semaglutide at about $167,000 per QALY versus phentermine-topiramate. Under realistic access barriers, cost-effectiveness fell 11% and averted obesity cases for semaglutide dropped from 57% to 3%, with the smallest gains among Medicaid-insured, Black, and Hispanic youth.