Incremental cost-effectiveness of evidence-based non-surgical weight loss strategies

2019 ◽  
Vol 9 (2) ◽  
pp. e12294 ◽  
Author(s):  
Eric A. Finkelstein ◽  
Naina R. Verghese
Keyword(s):  
Weight Loss ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Evidence Based ◽  
Surgical Weight Loss ◽  
Weight Loss Strategies

scholarly journals Cost-effectiveness of bone-anchored prostheses using osseointegrated fixation: Myth or reality?

2017 ◽  
Vol 42 (3) ◽  
pp. 318-327 ◽  
Author(s):  
Laurent Alain Frossard ◽  
Gregory Merlo ◽  
Brendan Burkett ◽  
Tanya Quincey ◽  
Debra Berg
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Lower Limb ◽  
Quality Adjusted Life Year ◽  
Incremental Cost Effectiveness Ratio ◽  
Decision Makers ◽  
Evidence Based ◽  
Cost Effectiveness Ratio ◽  
Limb Bone ◽  
Quality Adjusted Life

Background: In principle, lower limb bone-anchored prostheses could alleviate expenditure associated with typical socket manufacturing and residuum treatments due to socket-suspended prostheses. Objective: This study reports (a) the incremental costs and (b) heath gain as well as (c) cost-effectiveness of bone-anchored prostheses compared to socket-suspended prostheses. Study design: Retrospective individual case-controlled observations and systematic review. Methods: Actual costs were extracted from financial records and completed by typical costs when needed over 6-year time horizon for a cohort of 16 individuals. Health gains corresponding to quality-adjusted life-year were calculated using health-related quality-of-life data presented in the literature. Results: The provision of bone-anchored prostheses costed 21% ± 41% more but increased quality-adjusted life-years by 17% ± 5% compared to socket-suspended prostheses. The incremental cost-effectiveness ratio ranged between –$25,700 per quality-adjusted life-year and $53,500 per quality-adjusted life-year with indicative incremental cost-effectiveness ratio of approximately $17,000 per quality-adjusted life-year. Bone-anchored prosthesis was cost-saving and cost-effective for 19% and 88% of the participants, respectively. Conclusion: This study indicated that bone-anchored prostheses might be an acceptable alternative to socket-suspended prostheses at least from a prosthetic care perspective in Australian context. Altogether, this initial evidence-based economic evaluation provided a working approach for decision makers responsible for policies around care of individuals with lower limb amputation worldwide. Clinical relevance For the first time, this study provided evidence-based health economic benefits of lower limb bone-anchored prostheses compared to typical socket-suspended prostheses from a prosthetic care perspective that is essential to clinicians and decision makers responsible for policies.

scholarly journals Comparing Behavioral Weight Loss Modalities: Incremental Cost-Effectiveness of an Internet-Based Versus an In-Person Condition

Obesity ◽  
2011 ◽  
Vol 19 (8) ◽  
pp. 1629-1635 ◽  
Author(s):  
Rebecca A. Krukowski ◽  
J. Mick Tilford ◽  
Jean Harvey-Berino ◽  
Delia S. West
Keyword(s):  
Weight Loss ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Behavioral Weight Loss

scholarly journals Adding Evidence-Based Behavioral Weight Loss Strategies to a Statewide Wellness Campaign: A Randomized Clinical Trial

2014 ◽  
Vol 104 (7) ◽  
pp. 1300-1306 ◽  
Author(s):  
Tricia M. Leahey ◽  
Graham Thomas ◽  
Joseph L. Fava ◽  
Leslee L. Subak ◽  
Michael Schembri ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Weight Loss ◽  
Randomized Clinical Trial ◽  
Evidence Based ◽  
Behavioral Weight Loss ◽  
Weight Loss Strategies

scholarly journals A Digital Behavioral Weight Gain Prevention Intervention in Primary Care Practice: Cost and Cost-Effectiveness Analysis (Preprint)

2018 ◽  
Author(s):  
Anirudh Krishnan ◽  
Eric Andrew Finkelstein ◽  
Erica Levine ◽  
Perry Foley ◽  
Sandy Askew ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Cost Effectiveness ◽  
Black Women ◽  
Incremental Cost ◽  
Skills Training ◽  
Weight Gain Prevention ◽  
Post Intervention ◽  
Self Monitoring ◽  
Effectiveness Analysis

BACKGROUND Obesity is one of the largest drivers of health care spending but nearly half of the population with obesity demonstrate suboptimal readiness for weight loss treatment. Black women are disproportionately likely to have both obesity and limited weight loss readiness. However, they have been shown to be receptive to strategies that prevent weight gain. OBJECTIVE The aim of this study was to evaluate the costs and cost-effectiveness of a digital weight gain prevention intervention (Shape) for black women. Shape consisted of adaptive telephone-based coaching by health system personnel, a tailored skills training curriculum, and patient self-monitoring delivered via a fully automated interactive voice response system. METHODS A cost and cost-effectiveness analysis based on a randomized clinical trial of the Shape intervention was conducted from the payer perspective. Costs included those of delivering the program to 91 intervention participants in the trial and were summarized by program elements: self-monitoring, skills training, coaching, and administration. Effectiveness was measured in quality-adjusted life years (QALYs). The primary outcome was the incremental cost per QALY of Shape relative to usual care. RESULTS Shape cost an average of US $758 per participant. The base-case model in which quality of life benefits decay linearly to zero 5 years post intervention cessation, generated an incremental cost-effectiveness ratio (ICER) of US $55,264 per QALY. Probabilistic sensitivity analyses suggest an ICER below US $50,000 per QALY and US $100,000 per QALY in 39% and 98% of simulations, respectively. Results are highly sensitive to durability of benefits, rising to US $165,730 if benefits end 6 months post intervention. CONCLUSIONS Results suggest that the Shape intervention is cost-effective based on established benchmarks, indicating that it can be a part of a successful strategy to address the nation’s growing obesity epidemic in low-income at-risk communities.

scholarly journals Cost-Effectiveness of an Exercise Programme that Provided Group or Individual Training to Reduce the Fall Risk in Healthy Community-Dwelling People Aged 65–80: A Secondary Data Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 714
Author(s):  
Isaac Aranda-Reneo ◽  
Laura Albornos-Muñoz ◽  
Manuel Rich-Ruiz ◽  
María Ángeles Cidoncha-Moreno ◽  
Ángeles Pastor-López ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Older People ◽  
Incremental Cost ◽  
Fall Risk ◽  
Community Dwelling ◽  
Effective Measure ◽  
The Individual ◽  
The Cost ◽  
Individual Training

Research has demonstrated that some exercise programs are effective for reducing fall rates in community-dwelling older people; however, the literature is limited in providing clear recommendations of individual or group training as a result of economic evaluation. The objective of this study was to assess the cost-effectiveness of the Otago Exercise Program (OEP) for reducing the fall risk in healthy, non-institutionalized older people. An economic evaluation of a multicenter, blinded, randomized, non-inferiority clinical trial was performed on 498 patients aged over 65 in primary care. Participants were randomly allocated to the treatment or control arms, and group or individual training. The program was delivered in primary healthcare settings and comprised five initial sessions, ongoing encouragement and support to exercise at home, and a reinforcement session after six months. Our hypothesis was that the patients who received the intervention would achieve better health outcomes and therefore need lower healthcare resources during the follow-up, thus, lower healthcare costs. The primary outcome was the incremental cost-effectiveness ratio, which used the timed up and go test results as an effective measure for preventing falls. The secondary outcomes included differently validated tools that assessed the fall risk. The cost per patient was USD 51.28 lower for the group than the individual sessions in the control group, and the fall risk was 10% lower when exercises had a group delivery. The OEP program delivered in a group manner was superior to the individual method. We observed slight differences in the incremental cost estimations when using different tools to assess the risk of fall, but all of them indicated the dominance of the intervention group. The OEP group sessions were more cost-effective than the individual sessions, and the fall risk was 10% lower.

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