The review looked at how much anti‑obesity drugs cost compared to the health benefits they give. It found that tirzepatide works really well for weight loss, but it’s also pricey, so whether it’s worth it depends on your budget and situation. Other drugs like semaglutide give good results for less money, while cheaper options like phentermine‑topiramate or orlistat are more affordable but less powerful.

Obesity imposes a heavy burden on healthcare systems and society. Despite various treatment options, choosing cost-effective pharmacological interventions remains a key concern for health policymakers. This study systematically reviews economic evaluations of antiobesity drugs, comparing their costs and outcomes with those of lifestyle interventions. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four databases (PubMed, Scopus, Web of Science, and Embase) were searched for full economic evaluations of FDA-approved antiobesity drugs, including semaglutide, liraglutide, tirzepatide, phentermine-topiramate, and orlistat. Inclusion criteria required studies to report cost-effectiveness, cost-utility, or cost-benefit outcomes. Data on incremental cost-effectiveness ratios (ICERs), quality-adjusted life years (QALY), or disability-adjusted life years (DALY) were extracted and adjusted to 2024 USD using PPP. Study quality was assessed using CHEERS 2022. Fifteen studies met the inclusion criteria. Most used Markov models and cost-effectiveness analyses. The review of articles showed that 60% of the articles were conducted in the United States of America, 33.33% of the articles in Europe, and 6.66% of the articles in Australia. Among the reviewed studies, semaglutide was found to be the most cost-effective and clinically effective drug in most scenarios. Phentermine-topiramate showed acceptable cost-effectiveness, particularly in low-resource settings. Orlistat and naltrexone-bupropion were also considered affordable options, though with lower effectiveness. Tirzepatide, despite its high efficacy, demonstrated a higher ICER, making its cost-effectiveness context-dependent. These findings highlight the importance of integrating cost-effective pharmacological treatments into obesity management strategies. Semaglutide appears to be a highly effective and economically favorable option, while phentermine-topiramate and orlistat offer practical alternatives in resource-limited settings. Economic evaluations can inform policy decisions and optimize healthcare resource allocation in combating obesity.