GLP1R and obesity due to melanocortin 4 receptor deficiency: However, for expanding access for diabetic patients, obesity aside, in low-income and middle-income countries, GLP1-RA would require price reductions by approximately 98% (208 USD annually), to meet a common cost-effectiveness threshold of achieving incremental costs per incremental DALY averted less than three times the GDP per capita over sulfonylurea therapy alone [132].