A health economic model to assess the cost-effectiveness of OPTIFAST for the treatment of obesity in the United States.
OBJECTIVES
Obesity is associated with high direct medical costs and indirect costs resulting from productivity loss. The high prevalence of obesity generates a justified need to identify cost-effective weight loss approaches from a payer's perspective. Within the variety of weight management techniques, OPTIFAST is a clinically recognized and scientifically proven total meal replacement Low Calorie Diet that provides meaningful results in terms of weight loss and reduction in comorbidities. The objective of this study is assess potential cost-savings of the OPTIFAST program in the US, as compared to "no intervention" and pharmacotherapy.


METHODS
An event-driven decision analytic model was used to estimate payer's cost-savings from reimbursement of the 1-year OPTIFAST program over 3 years in the US. The analysis was performed for the broad population of obese persons (BMI >30 kg/m2) undergoing the OPTIFAST program vs liraglutide 3 mg, naltrexone/bupropion and vs "no intervention". The model included the risk of complications related to increased BMI. Data sources included published literature, clinical trials, official US price/tariff lists, and national population statistics. The primary perspective was that of a US payer; costs were provided in 2016 US dollars.


RESULTS
OPTIFAST leads over a period of 3 years to cost-savings of USD 9,285 per class I and II obese patient (BMI 30-39.9 kg/m2) as compared to liraglutide and USD 685 as compared to naltrexone/bupropion. In the same time perspective, the OPTIFAST program leads to a reduction of cost of obesity complications of USD 1,951 as compared to "no intervention", with the incremental cost-effectiveness ratio of USD 6,475 per QALY. Scenario analyses also show substantial cost-savings in patients with class III obesity (BMI ≥ 40.0 kg/m2) and patients with obesity (BMI = 30-39.9 kg/m2) and type 2 diabetes vs all three previous comparators and bariatric surgery.


CONCLUSIONS
Reimbursing OPTIFAST leads to meaningful cost-savings for US payers as compared with "no intervention" and liraglutide and naltrexone/bupropion in obese patients. Similar results can be expected in matching healthcare settings of other countries. Moreover, OPTIFAST has additional clinical and economic advantages through very low complication and adverse events rates.
['Nuijten|Mark|M|', 'Marczewska|Agnieszka|A|', 'Araujo Torres|Krysmaru|K|', 'Rasouli|Bahareh|B|', 'Perugini|Moreno|M|']
D050110:Bariatric Surgery D015992:Body Mass Index D016642:Bupropion D031204:Caloric Restriction D003362:Cost-Benefit Analysis D003924:Diabetes Mellitus, Type 2 D004338:Drug Combinations D006801:Humans D007004:Hypoglycemic Agents D000069450:Liraglutide D018803:Models, Economic D009271:Naltrexone D009765:Obesity D050177:Overweight D014481:United States D015431:Weight Loss D061217:Weight Reduction Programs
health economics model Optifast Obesity payer I11 I12 I18