The cost-effectiveness of sibutramine in non-diabetic obese patients: evidence from four Western countries.

This paper aims to assess the cost-effectiveness of sibutramine in treating obese patients in the Western countries. The model estimates the costs and quality of life benefits directly associated with weight losses combined with the costs and benefits associated with the reduced incidence of coronary heart disease (CHD) and diabetes. The pivotal effectiveness evidence is derived from a German multicentre, double-blind, randomized clinical trial on obese (body mass index >/= 30 Euro kg m(-2)) patients. The incremental cost per quality-adjusted life year ranges from 10,734 Euro in Switzerland to 13,707 Euro in Germany. The total number of CHD events avoided ranges from 1.96 for the UK to 4.49 for Switzerland. The number of diabetes cases avoided is in the region of 3.0 (ranges from 2.58 for Germany to 3.28 for Switzerland). The majority of costs and benefits are accrued through sibutramine treatment and monitoring. Univariate sensitivity analyses show that results are sensitive to changes in the utility directly attributable to weight losses. The results demonstrate that the benefits associated with sibutramine-induced weight losses are obtained at a reasonable cost in each of the settings explored and suggest that sibutramine treatment could be considered as a viable option for pharmacotherapy treatment alongside diet and exercise.