Cited by 35Health Systems, Economic Evaluations, Quality of LifePharmacology and Obesity TreatmentBariatric Surgery and Outcomes

Is Doctor Referral to a Low‐Energy Total Diet Replacement Program Cost‐Effective for the Routine Treatment of Obesity?

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Kent, Seamus, Aveyard, Paul, Astbury, Nerys, Mihaylova, Borislava, Jebb, Susan A.·2019·Obesity

Abstract

Objective: The study objective was to estimate the cost‐effectiveness of a commercially provided low‐energy total diet replacement (TDR) program compared with nurse‐led behavioral support. Methods: A multistate life table model and the weight reduction observed in a randomized controlled trial were used to evaluate the quality‐adjusted life‐years and direct health care costs (in United Kingdom 2017 prices) over a lifetime with TDR versus nurse‐led support in adults who had obesity, assuming that (i) weight returns to baseline over 5 years and (ii) a 1‐kg weight loss is maintained after 5 years following TDR. Results: The per‐person costs of the TDR and nurse‐led programs were £796 and £34, respectively. The incremental cost‐effectiveness ratio of TDR was £12,955 (95% CI: £8,082‐£17,827) assuming that all weight lost is regained and £3,203 (£2,580‐£3,825) assuming that a 1‐kg weight loss is maintained after 5 years. TDR was estimated to be more cost‐effective (i.e., lower incremental cost‐effectiveness ratios) in older adults and those with a higher BMI, with little difference by gender. Conclusions: At current retail prices and with plausible long‐term weight regain trajectories, TDR is projected to be cost‐effective in adults with obesity and could be considered as an option to treat obesity in routine health care settings.

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Authors
Kent, S., Aveyard, P., Astbury, N., Mihaylova, B., & Jebb, S. A.
Affiliations
  • University of Oxford (GB)
  • Queen Mary University of London (GB)
Corresponding author
Kent, Seamus
Venue
Obesity
Publisher
Wiley
Published
2019-02-25
Volume
27
Issue
3
Pages
391-398
ISSN
  • 1930-7381 (ISSN-L)
  • 1930-739X
OpenAlex
W2922148072
Cited by
35
References
39
Citations by year
2026: 4 · 2025: 6 · 2024: 7 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 2 · 2019: 4
FWCI
4.36
Type
journal article
Language
en
Open access
Locations
  • Obesity (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
Cambridge Weight Plan UK Ltd
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords
total diet replacement, cost-effectiveness, weight regain, quality-adjusted life years, health care costs, weight loss maintenance, commercial weight loss programs
MeSH terms
Adult, Aged, Cost-Benefit Analysis, Female, Humans, Male, Middle Aged, Obesity, Referral and Consultation, Weight Loss, Young Adult

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