Ella Zomer1,2, Rachel Leach1, Christine Trimmer1, Tim Lobstein1, Stephen Morris3, William P James1,4, Nick Finer1,5. 1. World Obesity Federation (formerly the International Association for the Study of Obesity), London, UK. 2. Department of Epidemiology and Preventive Medicine Monash University, Melbourne, Australia. 3. Department of Applied Health Research University College London, London, UK. 4. Department of Population Health London School of Hygiene and Tropical Medicine, London, UK. 5. National Centre for Cardiovascular Preventions and Outcomes, University College London, London, UK.
Abstract
BACKGROUND: Overweight/obesity is associated with significant morbidity, mortality and costs. Weight loss has been shown to reverse some of these effects, reducing the risk of chronic diseases such as cardiovascular disease (CVD). AIM: To determine the potential monies available, from an English National Health Service perspective, for weight loss interventions to be cost-effective in the prevention of CVD. METHODS: A Markov model was developed, populated with overweight/obese individuals from the Health Survey for England, aged 30-74 years, free of pre-existing CVD and with available risk factor information to calculate CVD risk. All individuals were free of CVD at baseline and, with each annual cycle, could transition to other health states of primary CVD, secondary CVD or death according to transition probabilities for a maximum period of 10 years, or until death. Utilities, costs and the effects of weight loss on CVD risk factors were applied. The potential monies available for CVD prevention strategies, provided the incremental cost-effectiveness ratio met UK arbitrary limits of between £20 000 and £30 000, was determined. RESULTS: Applying the effects of weight loss on CVD risk factors prevented 4 CVD events and saved 17 quality-adjusted life-years over 10 years per 1000 individuals. £34 to £51 was available per person per year for up to 10 years when meeting the UK arbitrary limits. CONCLUSIONS: Individual annual financial allowances for weight loss interventions to be considered cost-effective is relatively low; however, as a large proportion of the population is affected, wide cheap societal interventions are important.
BACKGROUND: Overweight/obesity is associated with significant morbidity, mortality and costs. Weight loss has been shown to reverse some of these effects, reducing the risk of chronic diseases such as cardiovascular disease (CVD). AIM: To determine the potential monies available, from an English National Health Service perspective, for weight loss interventions to be cost-effective in the prevention of CVD. METHODS: A Markov model was developed, populated with overweight/obese individuals from the Health Survey for England, aged 30-74 years, free of pre-existing CVD and with available risk factor information to calculate CVD risk. All individuals were free of CVD at baseline and, with each annual cycle, could transition to other health states of primary CVD, secondary CVD or death according to transition probabilities for a maximum period of 10 years, or until death. Utilities, costs and the effects of weight loss on CVD risk factors were applied. The potential monies available for CVD prevention strategies, provided the incremental cost-effectiveness ratio met UK arbitrary limits of between £20 000 and £30 000, was determined. RESULTS: Applying the effects of weight loss on CVD risk factors prevented 4 CVD events and saved 17 quality-adjusted life-years over 10 years per 1000 individuals. £34 to £51 was available per person per year for up to 10 years when meeting the UK arbitrary limits. CONCLUSIONS: Individual annual financial allowances for weight loss interventions to be considered cost-effective is relatively low; however, as a large proportion of the population is affected, wide cheap societal interventions are important.
Authors: Amanda S Hinerman; Emma J M Barinas-Mitchell; Samar R El Khoudary; Anita P Courcoulas; Abdus S Wahed; Wendy C King Journal: Surg Obes Relat Dis Date: 2020-04-19 Impact factor: 4.734
Authors: Eimear Leyden; Petra Hanson; Louise Halder; Lucy Rout; Ishbel Cherry; Emma Shuttlewood; Donna Poole; Mark Loveder; Jenny Abraham; Ioannis Kyrou; Harpal S Randeva; F T Lam; Vinod Menon; Thomas M Barber Journal: Clin Endocrinol (Oxf) Date: 2020-11-06 Impact factor: 3.478