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 In a new analysis, the popular Weight Watchers program and the drug
Qsymia were the most cost-effective strategies to lose weight. If a
third-party payer didn't cover the high cost of Jenny Craig's food,
that would be the most effective plan, the study found.
“To me the main message is that there are only a few viable options
for weight loss,” Eric Finkelstein told Reuters Health in an email.
“(Weight Watchers) and Qsymia currently provide the best bang for
the buck but Jenny Craig is most effective.”
Finkelstein is the study’s lead author from the Duke-National
University of Singapore Graduate Medical School and the Duke Global
Health Institute. He’s also worked with Jenny Craig, Weight Watchers
and a number of companies that manufacture weight loss drugs.
Previous studies, many funded by the companies, have found
commercial programs to be effective at getting people to lose weight
and even control their diabetes (see Reuters Health stories of April
23, 2014 and October 5, 2011 here: http://reut.rs/1pWhKGv and here:
http://reut.rs/QyhiUE).
Insurers and employers are under increasing pressure to cover weight
loss strategies for their customers and employees, Finkelstein said.
“As such, they care both about the costs and potential benefits,” he
said. “To date, no study has been conducted that compares all
programs against each other.”
For the new analysis, Finkelstein and his co-author reviewed
randomized controlled trials – the “gold standard” of medical
research – that evaluated non-surgical weight loss strategies over
at least one year.
They then paired those results with data on prices to estimate the
cost per kilogram of weight loss and cost per "quality adjusted life
year," which is the cost for each year of life gained by using the
program or drug.
After excluding studies that lasted less than a year or had other
problems, their analysis included Weight Watchers and Vtrim, both
diet and lifestyle programs, the Jenny Craig meal-replacement
program and the drugs Qsymia, Lorcaserin and Orlistat.
The researchers found that the average cost per kilogram (2.2
pounds) lost ranged from about $155 for Weight Watchers to about
$546 with the Roche drug Orlistat, which is available by
prescription as Xenical or over-the-counter as Alli.
The second most cost-effective strategy at about $204 per kilo was
Qsymia, a drug from VIVUS, Inc., which provided some support for the
study.
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The Vtrim program was the third most cost-effective strategy per
kilo of weight lost, followed by Jenny Craig, the drug lorcaserin –
marketed as Belviq by Arena Pharmaceuticals GmbH. Orlistat was the
most expensive per kilo.
Insurers and policymakers often prefer to consider treatments based
on their cost per quality adjusted life year gained, and typically
interventions are considered effective if that cost is less than
$50,000.
The researchers found that Weight Watchers, at $34,630, was the
cheapest program per quality adjusted life year gained. It was
followed by Qsymia, which is more effective at fostering weight
loss, but more expensive at $54,130 per quality adjusted life year
gained.
“As an individual the choice of which to choose should be based on
perceived costs and benefits and all may be viable options given
(their) benefits that extend beyond (cost-effectiveness) analysis,”
Finkelstein said. Those benefits include the taste of food and
convenience, for example.
As someone paying for the program, however, he said he would limit
his investment to programs proven to work and those that have the
participant take on some cost responsibility, such as weight loss
success.
Finkelstein also cautioned that these results are based on clinical
trial results. Participants often receive the programs, food or
drugs for free.
“Real world results could be better or worse,” he said.
SOURCE: http://bit.ly/1p8K6AT
Obesity, online June 24, 2014.
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