title: Pharmaceutical cost savings of treating obesity with weight loss medications.
abstract: OBJECTIVE
  To evaluate, in compliant patients, the pharmaceutical costs of treating obesity with fenfluramine/mazindol, fenfluramine/phentermine, caffeine/ephedrine, or mazindol relative to the pharmaceutical costs of treating obesity-related comorbid conditions and reducing cardiovascular risk.
  
  
  METHODS
  Subjects were between 18 and 60 years of age with a BMI of >30 kg/m2. Pharmaceutical costs were evaluated in 73 of 220 subjects taking medications for diabetes, hyperlipidemia, or hypertension before and after treatment using fenfluramine with mazindol or phentermine. The pharmaceutical cost of weight loss, cardiac risk reduction, and low-density lipoprotein (LDL) cholesterol reduction was calculated for fenfluramine with mazindol or phentermine, caffeine with ephedrine, or mazindol alone, and compared to approved lipid-lowering medications.
  
  
  RESULTS
  Losses of 6% to 10% of initial body weight reduced pharmacy costs $122.64/month for insulin treated diabetes, $42.92/month for sulfonylurea-treated diabetes, $61.07/month for hyperlipidemia treated with medication, and $0.20/month for hypertension treated with medication. Blood pressure and laboratory evidence of insulin resistance improved in all medication groups. Caffeine/ephedrine was most cost-effective of the three treatments in reducing weight, cardiac risk, and LDL cholesterol.
  
  
  CONCLUSIONS
  Obesity medications produced a substantial weight loss in compliant patients and resulted in a net pharmaceutical cost savings compared to treating obesity related comorbid conditions.
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA 70808-4124, USA. greenwfl@mhs.pbrc.edu
authors.forename: F L
authors.initials: FL
authors.lastname: Greenway
authors.forename: D H
authors.initials: DH
authors.lastname: Ryan
authors.forename: G A
authors.initials: GA
authors.lastname: Bray
authors.forename: J C
authors.initials: JC
authors.lastname: Rood
authors.forename: E W
authors.initials: EW
authors.lastname: Tucker
authors.forename: S R
authors.initials: SR
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D001067:Appetite Depressants / Q000627:therapeutic use*; D002110:Caffeine / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000188:drug therapy; D016527:Drug Costs; D004809:Ephedrine / Q000627:therapeutic use; D005260:Female; D005277:Fenfluramine / Q000627:therapeutic use; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy / Q000209:etiology; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008454:Mazindol / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D010645:Phentermine / Q000627:therapeutic use; D012307:Risk Factors; D015431:Weight Loss
chemical_list: D001067:Appetite Depressants; D005277:Fenfluramine; D002110:Caffeine; D010645:Phentermine; D008454:Mazindol; D004809:Ephedrine