A Meal Replacement Program for the Treatment of Obesity: A Cost-Effectiveness Analysis from the Swiss Payer's Perspective

Mark Nuijten; Livia Dainelli; Bahareh Rasouli; Krysmaru Araujo Torres; Moreno Perugini; Agnieszka Marczewska

doi:10.2147/DMSO.S284855

A Meal Replacement Program for the Treatment of Obesity: A Cost-Effectiveness Analysis from the Swiss Payer's Perspective

Diabetes Metab Syndr Obes. 2021 Jul 8:14:3147-3160. doi: 10.2147/DMSO.S284855. eCollection 2021.

Authors

Mark Nuijten¹, Livia Dainelli², Bahareh Rasouli³, Krysmaru Araujo Torres⁴, Moreno Perugini⁵, Agnieszka Marczewska²

Affiliations

¹ Health Economics and Valuation, A2M, Amsterdam, the Netherlands.
² Global Market Access & Pricing, Nestlé Health Science, Vevey, Switzerland.
³ Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁴ Medical Affairs, US Nestlé Health Science, Bridgewater, MA, USA.
⁵ Commercial and Medical Affairs, Pharmaceuticals, Nestlé Health Science, Bridgewater, MA, USA.

Abstract

Background: Obesity is a disease associated with high direct medical costs and high indirect costs resulting from productivity loss. The high prevalence of obesity generates the need for payers to identify cost-effective weight loss approaches. Among various weight management techniques, the OPTI (Optifast^®) program is a clinically recognised total meal replacement diet that can lead to significant weight loss and reduction in complications. This study's objective is to assess OPTI program's cost-effectiveness in Switzerland in comparison to "no intervention" and pharmacotherapy.

Methods: An event-driven decision-analytic model was used to estimate the payer's cost savings through the reimbursement of OPTI program over a 1-year period as well as a lifetime in Switzerland. The analysis was performed on a broad population of people with obesity with a body mass index (BMI) higher than 30 kg/m² following the OPTI program vs two comparators (liraglutide and "no intervention"). The model incorporated a higher risk of complications due to an increased BMI and their related healthcare costs. Data sources included published literature, clinical trials, official Swiss price/tariff lists and national population statistics. The primary perspective was that of a Swiss payer. Scenario analyses - for example, for patients with existing complications (such as myocardial infarction, stroke, type 2 diabetes mellitus) or severe obesity - were conducted to test the robustness of the results.

Results: The OPTI program results in cost savings of CHF 20,886 (€ 18,724) and CHF 15,382 (€ 13,790) per person compared with "no intervention" and liraglutide 3 mg, respectively. In addition, OPTI program led to 1.133 and 0.734 quality-adjusted life years (QALYs) gained respectively against its comparators. Scenario analyses showed similar outcomes with cost savings and QALYs gained.

Conclusion: OPTI program is a dominant strategy compared to "no intervention" and liraglutide 3 mg as it leads to both cost savings and QALY gain. Therefore, reimbursing the OPTI program for patients with obesity would be cost-effective for Swiss payers.

Keywords: OPTI program; cost-effectiveness; obesity; total meal replacement.

Grants and funding

Nestlé Health Science. The role of the funder consisted in scientific contribution to the development of the model and review of the manuscript.