Budget impact of GLP-1 and dual GIP/GLP-1 receptor agonists for obesity management in Saudi Arabia: a budget impact analysis from public and private payer perspectives

Abstract Background Obesity is highly prevalent worldwide, including in Saudi Arabia, where it significantly contributes to chronic disease burden and rising healthcare expenditures. The introduction of highly effective novel anti-obesity medications (AOMs), such as glucagon-like peptide-1 (GLP-1) receptor agonists and dual glucose-dependent insulinotropic polypeptide (GIP)-GLP-1 receptor agonists, has expanded treatment options. However, their high cost raises concerns about affordability. Country-specific budget impact estimates are essential for informing coverage and reimbursement decisions for novel anti-obesity medications in Saudi Arabia. Methods A budget impact analysis was conducted to estimate the financial consequences of adopting novel AOMs in Saudi Arabia over 5- and 10-year horizons. A static cohort model was applied from both public (Ministry of Health) and private (Council of Cooperative Health Insurance) payer perspectives. Adult population and obesity prevalence data were obtained from GASTAT and the Saudi Health Interview Survey, while comorbidity prevalence was sourced from Ministry of Health reports and published studies. Drug acquisition costs were derived from SFDA price lists and NUPCO procurement data. Two eligibility scenarios were evaluated: (1) BMI ≥ 30 kg/m² alone and (2) BMI ≥ 30 kg/m² with at least one obesity-related comorbidity. Uptake, adherence, and discontinuation rates were informed by clinical trials (STEP and SURPASS programs) and adjusted for the Saudi healthcare context. Results Under the BMI plus comorbidity scenario, cumulative 10-year expenditure was estimated at SAR 10.96 billion for public payers and SAR 5.68 billion for private payers. Expanding eligibility to all individuals with BMI ≥ 30 kg/m² increased cumulative public expenditure to SAR 18.9 billion over 10 years. Uptake rate and drug acquisition cost were the most influential parameters in sensitivity analyses. Conclusion Novel anti-obesity medications may substantially increase healthcare expenditure in Saudi Arabia, particularly under broad eligibility criteria. Restricting reimbursement to higher-risk populations and implementing phased uptake strategies may improve affordability while preserving access to effective obesity treatments. Clinical trial number Not applicable.