*

ICER rates semaglutide and tirzepatide as cost effective

vs

lifestyle modifications

*

Lilly's tirzepatide shows "promising but inconclusive"

cost-effectiveness vs Novo's semaglutide

*

Net prices of both drugs have fallen "a ton"

By Deena Beasley

Sept 9 (Reuters) - An influential drug pricing watchdog

on Tuesday said popular GLP-1 weight-loss injections have become

more cost-effective as their prices have fallen and studies have

shown proof of their cardiovascular health benefits.

In a draft report, the Institute for Clinical and Economic

Review gave its highest cost-effectiveness rating to both Novo

Nordisk's semaglutide, sold as Ozempic and Wegovy,

and Eli Lilly's ( LLY ) tirzepatide, sold as Mounjaro and

Zepbound, for weight loss compared to lifestyle modifications

such as diet and increased exercise.

The cost analysis follows an April report from the small but

influential Boston-based research group highlighting the need to

make the widely-prescribed drugs more affordable.

"Prices have come down a ton," in the last couple of years,

ICER Chief Medical Officer Dr. David Rind told Reuters. But due

to high demand, "payers are having a lot of problems with

affordability of these drugs," he said.

Around 40% of U.S. adults are obese, according to the

Centers for Disease Control and Prevention. A recent study found

that U.S. spending on GLP-1 drugs, which in trials led to weight

loss of 15%-20%, reached nearly $72 billion in 2023.

ICER said evidence that Lilly's drug is more

cost-effective than Novo Nordisk's medication is "promising but

inconclusive."

"We know for certain that tirzepatide has greater weight

loss and strongly suspect fewer gastrointestinal side effects,"

Rind said. "What we don't really know is whether the

cardiovascular outcomes are better, worse or the same," he said

of the drugs' ability to significantly lower the risk of serious

heart problems.

In obese patients with heart disease, injectable semaglutide

has been shown to reduce the risk of major cardiovascular events

and death, while tirzepatide has been shown to reduce risks for

obese adults with a common type of heart failure.

In a 2022 report before tirzepatide was approved for weight

loss, the group rated semaglutide's cost-effectiveness as

slightly lower than the current report.

ICER said an oral version of semaglutide that is now under

regulatory review is cost-effective compared to lifestyle

changes, but was less certain about its value compared to the

injected version. It did not assess the GLP-1 pill orforglipron

that Lilly is expected to submit to regulators this year.

ICER estimated the current U.S. annual net price for Novo's

semaglutide at $6,830, down from $13,618 in its 2022 analysis.

It used a net price of $7,973 for Lilly's tirzepatide, which has

a U.S. list price of around $13,000. Both companies sell their

drugs directly to consumers for about $6,000 a year.

ICER will hold a public meeting on the draft report in

November, after which it will issue a final report.

More than half of large U.S. employers plan to scale back

healthcare benefits next year as rising costs from weight-loss

and specialty drugs squeeze budgets, according to a recent

survey by consulting firm Mercer.

ICER's Rind said cost-effectiveness of the GLP-1 drugs

remains "a moving target" given additional studies underway and

the fact that semaglutide is one of several drugs under

negotiation with the federal government's Medicare plan, with

that price expected to be announced in November.

For those without insurance coverage for GLP-1s, the

direct-to-consumer route "is a good use of dollars" for people

who can afford it, he said.

"But what's going on is that we're not providing resources

to many of the people who would most benefit from these

therapies... It would be better if we figured out a national way

to improve affordability across the broad set of patients," Rind

said.