Table 14 Cost-effectiveness Outcomes: Weight Management

CUA

Mean cost per participant

Group 1: $145; Group 2: $160. Group 3: $390

Mean weight loss (%)

Group 1: 4.1%,

Group 2: 3.9%,

Group 3: 5.3%.

ICER (cost per 1% weight loss) vs “do nothing” approach; Group 3 vs Group 1 & 2.

Group1: $30,

Group 2: $40,

Group 3: £70; $200.

Cost-effective “Extrapolation of savings for the entire TRICARE population would significantly reduce direct medical costs”

Mean life year gain

Group 1: 0.17,

Group 2: 0.16,

Group 3: 0.21.

ICER (cost per life year gained) vs “do nothing” approach; Group 3 vs Group 1 & 2.

Group 1: $900, Group 2: $1000, Group 3: $1800; $4200–$5300.

ICER (cost per QALY gained) vs “do nothing approach”;

Group 3 vs Group 1 & 2.

Group 1: $900,

Group 2: $1100,

Group 3: $1900; $4400–$5600.

Mean QALY gain

Group 1: 0.16;

Group 2: 0.15;

Group 3: 0.20.

CEA (kg decrease in weight)

Total costs

Intervention:

(Low dose): $16,351,

(Moderate) $19,426,

(High): $26,630; Control: $13,233;

Mean % initial body weight lost (kg) at 6 months

Intervention:

Low dose: 7.2% (95%CI 6.1, 8.3),

Moderate: 9.3% (95%CI 8.2, 10.3)

High dose: 10.9% (9.8,11.9); Control: 4.1%

(95% CI:3.1, 5.1)

ICER Cost per kg lost per participant

Low $33; Moderate: $22; High: $25; Control:$28

Low-dose treatment is less effective and less cost-efficient than moderate-dose. A moderate dose can produce clinically meaningful, two-year reductions in body weight comparable to high-dose treatment, at a lower cost.

(Unclear. ICER estimate for 2 years is lower for high dose than moderate. At six months there is a dose-response relationship between the interventions compared to control).

Cost per participant

Intervention (Low dose): $111, (Moderate): $145,

(High): $165 Control: $78.

Mean % initial body weight lost (kg) at 24 months:

Intervention:

Low dose: 3.5% (95%CI 2.0, 4.8),

Moderate: 6.7% (95%CI 5.3, 7.9)

High: 6.8% (5.5,8.1);

Control: 2.9% (95% CI: 1.7, 4.3) at 24 months