Pharmaceutical cost savings of treating obesity with weight loss medications.
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.
Greenway
F L
FL
Pennington Biomedical Research Center, Baton Rouge, LA 70808-4124, USA. greenwfl@mhs.pbrc.edu
Ryan
D H
DH
Bray
G A
GA
Rood
J C
JC
Tucker
E W
EW
Smith
S R
SR
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
D001067:Appetite Depressants; D005277:Fenfluramine; D002110:Caffeine; D010645:Phentermine; D008454:Mazindol; D004809:Ephedrine