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, caff eine/ephedrine, or mazindol relative to the pharmaceutical costs of treatin g obesity-related comorbid conditions and reducing cardiovascular risk. Methods and Procedures: Subjects were between is and 60 years of age with a BMI of >30 kg/m(2). Pharmaceutical costs were evaluated in 73 of 220 subje cts taking medications for diabetes, hyperlipidemia, or hypertension before and after treatment using fenfluramine with mazindol or phentermine. The p harmaceutical cost of weight loss, cardiac risk reduction, and low-density lipoprotein (LDL) cholesterol reduction was calculated for fenfluramine wit h 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-t reated diabetes, $61.07/month for hyperlipidemia treated with medication, a nd $0.20/month for hypertension treated with medication. Blood pressure and laboratory evidence of insulin resistance improved in all medication group s. Caffeine/ephedrine was most cost-effective of the three treatments in re ducing weight, cardiac risk, and LDL cholesterol. Discussion: Obesity medications produced a substantial weight loss in compl iant patients and resulted in a net pharmaceutical cost savings compared to treating obesity related comorbid conditions.