Cost-Effectiveness of a Low-Calorie Diet and Orlistat for Obese Persons.

Background and Objective: Our study estimated the cost-effectiveness of pharmacologic treatment of obesity in combination with a low-calorie diet in the Tabriz.Materials and Methods:Costs and effects of a low-calorie diet-only intervention and of a low caloriedietincombinationwith1 year of or list at were compared to no treatment. The RIVM Chronic Disease Model was used to project the differences in quality adjusted life years (QALYs) and lifetime health-care costs because of the effects of the interventions on body mass index (BMI) status. This was done by linking BMI status to the occurrence of obesity-related diseases and by relating quality of life to disease status. Probabilistic sensitivity analysis was employed to study the effect of uncertainty in the model parameters. In univariate sensitivity analysis, we assessed how sensitive the results were to several key assumptions.Findings: Incremental costs per QALY gained were $17,900 for the low-calorie diet-only intervention compared to no intervention and $8,800 for the low-calorie diet + orlistat compared to the low-calorie diet only. Assuming a direct relation between BMI and quality of life, these ratios decreased to $6000perQALYgainedand $24,100perQALY gained. Costs per QALY gained were also sensitive to assumptions about long-term weight loss maintenance Conclusions: Cost-effectiveness ratios of interventions aiming at weight reduction depend strongly on assumptions regarding the relation between BMI and quality of life. We recommend that a low-calorie diet should be the first option for policymakers in combating obesity

Keywords:

cost-effectiveness analysis , modeling , obesity , orlistat