A within-trial cost-effectiveness analysis of primary care referral to a commercial provider for weight loss treatment, relative to standard care—an international randomised controlled trial

Abstract

Background:Due to the high prevalence of overweight and obesity there is a need to identify cost-effective approaches for weight loss in primary care and community settings.Objective:We evaluated the cost effectiveness of two weight loss programmes of 1-year duration, either standard care (SC) as defined by national guidelines, or a commercial provider (Weight Watchers) (CP).Design:This analysis was based on a randomised controlled trial of 772 adults (87% female; age 47.4±12.9 years; body mass index 31.4±2.6 kg m−2) recruited by health professionals in primary care in Australia, United Kingdom and Germany. Both a health sector and societal perspective were adopted to calculate the cost per kilogram of weight loss and the ICER, expressed as the cost per quality adjusted life year (QALY).Results:The cost per kilogram of weight loss was USD122, 90 and 180 for the CP in Australia, the United Kingdom and Germany, respectively. For SC the cost was USD138, 151 and 133, respectively. From a health-sector perspective, the ICER for the CP relative to SC was USD18 266, 12 100 and 40 933 for Australia, the United Kingdom and Germany, respectively. Corresponding societal ICER figures were USD31 663, 24 996 and 51 571.Conclusion:The CP was a cost-effective approach from a health funder and societal perspective. Despite participants in the CP group attending two to three times more meetings than the SC group, the CP was still cost effective even including these added patient travel costs. This study indicates that it is cost effective for general practitioners (GPs) to refer overweight and obese patients to a CP, which may be better value than expending public funds on GP visits to manage this problem.

The Population Cost‐Effectiveness of Weight Watchers with General Practitioner Referral Compared with Standard Care

“…In the current environment, primary care professionals, especially GPs, are working at capacity as well as facing an increasing number of patients with obesity in need of treatment . GPs have little more than the standard 20‐minute consultation within which to try to improve the management of patients with obesity, a complex, multifactorial chronic condition . The capacity for GPs to refer to an established commercial weight‐loss program (such as WW) offering cost savings provides an additional feasible treatment.…”

“…The WW cost used the market price of attending the program. For SC, the costs were for 10.7 GP consultations over the year, with a GP consultation lasting 20 minutes or less as per the Australian Medicare Benefits Schedule (item 23, http://www.mbsonline.gov.au). See Supporting Information Table S3 for a description of the intervention resources and unit costs.…”

Investigating general medication prescription by general practitioners during a 12‐month randomized controlled weight loss trial

“…We also showed that the CP was a cost‐effective treatment compared to SC, with both a within‐trial analysis and a modelled lifetime analysis . A sensitivity analysis was performed using the Australian medication costs per participant.…”

How much is your diet? (Estimation about prices of “traditional Hungarian”, diabetic, low energy diets, and related life-style expenses)

“…Based on the researchers' fi ndings, 2000-calorie diet would just cost $3.52 a day if it consisted of junk food, compared with $36.32 a day for a diet of low energy dense foods (PARKER-POPE, 2007). In the United Kingdom and in Germany, the cost of every lost kilogram from body weight was calculated as 122 USD (FULLER et al, 2013). Another US study examined the price elasticity of demand of sugarsweetened beverages, fast food restaurants, and fruit and vegetables.…”