TABLE 1.
Key Clinical, Utility, and Cost Inputs
| Cohort inputs | Value | Source |
|---|---|---|
| Baseline cohort characteristics | ||
| Age, y | 46.0 | Wilding et al,14 2021 |
| Female sex, % | 74.1 | |
| Male sex, % | 25.9 | |
| BMI | 37.9 | |
| SBP, mmHg | 126.0 | |
| Total cholesterol, mg/dL | 190.4 | |
| HDL cholesterol, mg/dL | 49.4 | |
| Proportion with prediabetes, % | 43.7 | |
| History of cardiovascular disease, % | 9.8 | |
| Clinical inputs | ||
| Minimum BMI for bariatric surgery | 35.0 | American Society for Metabolic and Bariatric Surgery49 |
| Annual incidence of bariatric surgery, % | 1.1 | English et al,50 2020 |
| Natural weight increase per year, kg | 0.5 | Ara et al,21 2012 |
| Cost inputs (2021 USD) | ||
| Cost of bariatric surgery (including costs associated with preoperative management, procedure, postsurgery follow-up, and complications) | $31,965.23 | Weiner et al,51 2013; Kizy et al,52 2017; Alsumali et al,53 2018; Lee et al,39 2020 |
| Cost of obesity monitoring per year | $622.50 | CMS Physician Fee Schedule 2021 |
| Utility inputs | ||
| BMI-specific utility | Utility range as 0.97-0.93 for the BMI domain of 30-42 (higher BMI is associated with lower utility) | Pi-Sunyer et al,35 2015 |
| Comorbidity disutilities | ||
| T2D | −0.07 | Shah et al,54 2020 |
| Post-ACS | −0.02 | Bhatt et al,55 2020 |
| OSA | −0.24 | Pietzsch et al,56 2015 |
| Cancer | −0.07 | Gough et al,57 2009 |
| Poststroke | −0.07 | Bhatt et al,55 2020 |
| Acute event disutilities | ||
| Bariatric surgery | −0.22 | Campbell et al,58 2010 |
| ACS | −0.03 | Bhatt et al,55 2020 |
| Knee replacement | −0.18 | Shah et al,54 2020 |
| Stroke | −0.09 | Shah et al,54 2020 |
| TIA | −0.07 | Bhatt et al,55 2020 |
| Treatment-specific inputs | Semaglutide 2.4 mg | Liraglutide 3 mg | Phentermine-topiramate | Naltrexone-bupropion | D&E | |
| Clinical inputs | ||||||
| Source | Wilding et al,14 2021 | Pi-Sunyer et al,35 2015, NNI data on file | Gadde et al,32 2011; Garvey et al,33 2012 | Greenway et al,34 2010; Apovian et al,31 2013 | Wilding et al,14 2021 | |
| Percentage change in BMI, % from baseline, mean (SE) | ||||||
| Month 6 | −11.7 (0.2) | −7.4 (0.1) | −8.7 (2.2) | −7.8 (0.2) | −2.8 (0.2) | |
| Year 1 | −14.9 (3.7) | −8.0 (0.1) | −9.6 (2.4) | −8.2 (2.1) | −2.4 (0.6) | |
| Year 2 | −17.6 (4.4) | −7.1 (0.2) | −9.3 (2.3) | −9.7 (2.4) | −2.8 (0.7) | |
| Response evaluation period, wk | 21 | 16 | 14 | 15 | 12 | |
| Titration period, wk | 16 | 5 | 2 | 3 | 0 | |
| Proportion of patients achieving response, % | — | 68.4 | 55.3 | 45.4 | 24.9 | |
| Years required to rebound to baseline weight after treatment discontinuation, y | 3 | 2 | 2 | 2 | 1 | |
| Cost inputs (2021 USD) | ||||||
| Source | IBM Redbook 2021,59 FDA Package Label 2021,25,28 FDA Package Label 2020,26,27 | |||||
| Titration period treatment cost, $ | 1,939.22 | 632.26 | 43.40 | 106.26 | — | |
| Annual maintenance treatment cost, $ | 17,597.48 | 16,459.72 | 2,264.55 | 3,696.33 | — | |
BMI was calculated as weight in kilograms divided by the square of height in meters.
— = not applicable; ACS = acute coronary syndrome; BMI = body mass index; D&E = diet and exercise; FDA = US Food and Drug Administration; HDL = high-density lipoprotein; IBM = International Business Machines Corporation; OSA = obstructive sleep apnea; SBP = systolic blood press; TIA = transient ischemic attack; T2D = type 2 diabetes; USD = United States dollar; wk = weeks; y = years.