PSY46 - A Cost-Utility Analysis of Lighterlife Total as a Treatment for Obesity in the United Kingdom

Abstract

LighterLife Total (LLT) is a weight loss programme for the obese (BMI ≥30kg/m2) combining a very low calorie diet (VLCD) with weekly support groups for behaviour modification. This study evaluated the cost-effectiveness of LLT compared with dietary and surgical interventions. This is the first study assessing the cost-effectiveness of a VLCD. A cohort model was developed to assess the reduction in BMI in the first 12 months following intervention with LLT, gastric banding, gastric bypass, Weight Watchers, Counterweight, Slimming World and no treatment, and the subsequent yearly BMI increase. Published all cause-mortality was applied by age and BMI. Co-morbidity prevalence (diabetes, colorectal cancer, CHD) was applied by BMI. Costs were applied for each intervention and for co-morbidities, from a UK health care perspective. Utilities were calculated by BMI with an additional decrement for co-morbidities. A 10 year time horizon was used. Analyses were run for two subgroups: BMI 30-40 in and BMI >40. BMI 30-40: compared against no treatment, Counterweight, Weight Watchers and Slimming World, LLT was associated with higher costs, but also greater QALYs and was cost-effective against all, with incremental cost-effectiveness ratios of £14,937, £16,004, £16,182, and £19,840, respectively. BMI >40: compared against no treatment LLT incurred higher costs, but also greater QALYs and was cost-effective (ICER = £5,349). LLT was less effective than banding and bypass. The budget impact of uptake of LLT across the UK was assessed for both BMI 30-40 and BMI >40 groups. BMI 30-40: LLT was more costly than dietary interventions, but lead to increased QALYs and was estimated to be cost-effective. BMI >40: LLT resulted in a lower initial BMI reduction than gastric banding and bypass. LLT was estimated to be cost-effective against no treatment in both groups.