Vivus’ Qsymia beats out weight loss competitors in pricing watchdog's latest cost-effectiveness analysis

13 Jul 2022
endpts.com
Generic DrugAcquisition
Cost-effectiveness watchdog ICER took a look at several different drugs approved for obesity and weight loss — and to them, there is a clear winner. ICER determined that Vivus’ Qsymia, the brand name for the appetite suppressant phentermine combined with the anticonvulsant topiramate, was more cost effective for weight loss than other competitors such as Novo Nordisk’s Saxenda and Ozempic. “When treatments were compared with each other, phentermine/topiramate plus lifestyle modification was less costly and more effective than bupropion/naltrexone plus lifestyle modification,” the reviewers said in their analysis. ICER noted in its draft report published Wednesday, “Medications for Obesity Management: Effectiveness and Value,” that medical costs related to obesity can be costly. It’s estimated that annual costs as far back as 2016 were around $260 billion. The new analysis from the cost-effectiveness watchdog group comes more than two weeks after FDA expanded Qsymia’s label to now include adolescents ages 12 and up. Granted, the approval was on the condition that the drug is given on top of both a reduced-calorie diet and increased physical activity. Vivus nabbed approval for Qsymia in adults in 2012, then saw poor sales numbers. The company ended up filing for bankruptcy and becoming a subsidiary of Icahn Enterprises LP. Outside Qsymia, the authors examined three other drugs: Bupropion and naltrexone, a combination of an antidepressant drug and an anti-addiction drug marketed by Currax Pharmaceuticals as Contrave, and two of Novo Nordisk’s diabetes/weight loss drugs, GLP-1 antagonists liraglutide (Saxenda) and semaglutide (Ozempic). While ICER crowned Qsymia the overall winner, other options may come in handy for different patients, the reviewers said. “For patients not achieving desired weight loss or unable to tolerate phentermine/topiramate, bupropion/naltrexone may be a cost-effective alternative,” they noted, adding that semaglutide, while more effective, was more costly and did not meet “commonly-accepted cost-effectiveness thresholds.” “As such, semaglutide might be considered in patients not achieving desired weight loss or unable to tolerate phentermine/topiramate and bupropion/naltrexone, but only with a significant discount,” the authors said. The wholesale acquisition cost (WAC) for the drug is more than $17,000 for a year’s supply. Although Qsymia has a WAC of only $2,382 for a year’s supply, the drug can cause fetal harm if taken while pregnant, including an increased risk of cleft lips and cleft palates. The drug also won’t have market exclusivity for too much longer. Generics players Actavis (part of Teva) and Dr. Reddy’s reached deals with Vivus in 2017 that will allow Qsymia generics to enter the market starting in December 2024 and into 2025. Bupropion and naltrexone reported a WAC of $7,393 for a year’s supply, and the other Novo drug (Saxenda) was not too far below semaglutide’s $17,000-plus yearly price, clocking in at $15,795. ICER also noted in its report that there were a few limitations to its analysis, including the full impact of the drugs in patients with chronic kidney diseases or other conditions where weight loss may be beneficial, such as cancer.
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