Purpose: The economic costs of obesity extend to the management of obesity-related comorbidities, including hypertension, dyslipidemia, and type 2 diabetes mellitus (T2DM). This post hoc analysis evaluated changes in annual antihypertensive, lipid-lowering, and antidiabetic medication costs among obese and overweight subjects receiving placebo or phentermine and topiramate extended-release (PHEN/TPM ER) in the CONQUER study.
Methods: CONQUER was a double-blind, placebo-controlled, Phase 3 trial of 2487 obese and overweight subjects (body-mass index [BMI] ≥27 and ≤45 kg/m2) with ≥2 weight-related comorbidities randomized to placebo (n=994), PHEN 7.5 mg/TPM ER 46 mg (7.5/46; n=498), or PHEN 15 mg/TPM ER 92 mg (15/92; n=995) plus lifestyle modifications for 56 weeks. Subjects included in this post hoc analysis completed ≥12 weeks of therapy and received medications at baseline or endpoint for the treatment of ≥1 of the following comorbidities: hypertension (n=830), dyslipidemia (n=340), or T2DM (n=207). Annual antihypertensive, lipid-lowering, and antidiabetic medication costs were calculated at baseline and end of treatment by multiplying unit cost (Medi-Span's PriceRx database) by number of doses per day and by 365.
Results: Most subjects were female (70%) and Caucasian (86%); mean weight was 103.1±17.9 kg and mean BMI was 36.6±4.5 kg/m2. At end of treatment, least-squares mean percent weight loss was significantly greater in subjects receiving PHEN/TPM ER vs placebo in all subgroups (P<.001, all comparisons). At end of treatment, changes in annual antihypertensive, lipid-lowering, and antidiabetic medication costs were greater with PHEN/TPM ER than with placebo (Table). For hypertension, the changes in annual medication cost vs placebo were -$109.19 and -$118.57 for 7.5/46 and 15/92, respectively; for dyslipidemia, were -$186.66 and -$179.14 for 7.5/46 and 15/92, respectively; and for T2DM, were -$125.09 and -$205.39 for 7.5/46 and 15/92, respectively. Common treatment-emergent adverse events were constipation, dry mouth, and paraesthesia.
Conclusions: PHEN/TPM ER induced significant weight loss vs placebo and was associated with reduced annual medication costs for the treatment of hypertension, dyslipidemia, and T2DM. This suggests that PHEN/TPM ER–induced weight loss may help decrease the medication cost burden of obesity by reducing the need for concomitant medications.
