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Orlistat in responding obese type 2 diabetic patients: meta-analysis findings and cost-effectiveness as rationales for reimbursement in Sweden and Switzerland

International Journal of Obesity volume 29, pages 517–523 (2005)Cite this article

Abstract

OBJECTIVE:

The aim of this study is to review the clinical and economic rationale for the reimbursement of orlistat in responding obese patients with type 2 diabetes.

METHODS:

Data from seven randomized controlled clinical trials of orlistat in overweight and obese patients with type 2 diabetes were pooled. A subgroup analysis involving patients who achieved a response (defined as a weight loss of ≥5% after 12 weeks of treatment) was conducted. The outcomes of the pooled analysis were then used to construct a Markov health economic model covering an 11-y period. The incidences of diabetes-related micro- and macrovascular complications were derived from the United Kingdom Prospective Diabetes Study. The effects of changes in body mass index, and the impact of micro- and macrovascular complications on utilities were derived from published sources. Publicly available cost data were used and are presented here in 2001 Euros. Discounting of 3% was applied. A probabilistic sensitivity analysis was conducted to examine the robustness of results.

RESULTS:

A total of 1249 patients treated with orlistat and 1230 given placebo were eligible for the intent-to-treat analysis. At the end of the study period, 23% of orlistat patients achieved a weight reduction of ≥5%. These patients showed a mean decrease in HbA1C of 1.16%, a weight reduction of 8.6 kg, a reduction in total cholesterol of 5.3% and a reduction in systolic blood pressure of 5.2 mmHg. The base-case economic analysis revealed costs per quality-adjusted life year gained of €14 000 in Sweden and €13 600 in Switzerland.

CONCLUSION:

The data presented here support the utilization and reimbursement of orlistat in overweight and obese diabetic patients who respond to the treatment.

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Authors and Affiliations

  1. Health Services Research Unit, Division of Rheumatology, Center of Internal Medicine, Hannover Medical School, Hannover, Germany

    J Ruof

  2. Global Health Economics Department, Roche Pharmaceuticals, Basel, Switzerland

    J Ruof

  3. Teaching Diabetic Division, University Hospital, Geneva, Switzerland

    A Golay

  4. Department of Medicine, University Hospital, Uppsala, Sweden

    C Berne

  5. Business Development, Roche Pharmaceuticals, Stockholm, Sweden

    C Collin

  6. Roche Pharmaceuticals, Reinach, Switzerland

    J Lentz

  7. University Health Network, Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

    A Maetzel

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  1. J Ruof
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Correspondence to J Ruof.

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Ruof, J., Golay, A., Berne, C. et al. Orlistat in responding obese type 2 diabetic patients: meta-analysis findings and cost-effectiveness as rationales for reimbursement in Sweden and Switzerland. Int J Obes 29, 517–523 (2005). https://doi.org/10.1038/sj.ijo.0802925

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