Table 1. Base-Case Model Inputs.
| Parameter | Base case (range) | Comments | Distribution | Source |
|---|---|---|---|---|
| Treatment-related probabilities or outcomes | ||||
| Monthly change in BMI with ESG (year 1) | −0.40 (−0.36 to −0.44) | ±10% | Normal | Abu Dayyeh et al,17 2022 (MERIT) |
| Monthly change in BMI with ESG (years 2-5) | 0.0065 (0.0059 to 0.0072) | ±10% | Normal | Hedjoudje et al,12 2020; Sharaiha et al,18 2021 |
| Monthly change in BMI with semaglutide (year 1) | −0.34 (−0.31 to −0.38) | ±10% | Normal | Wilding et al,15 2021 (STEP 1 trial) |
| Monthly change in BMI with semaglutide (years 2-5) | 0.0012 (0.0013 to 0.0011) | ±10% | Normal | Marso et al,19 2016 |
| Monthly change in BMI for dropouts | 0.138 (0.124 to 0.152) | ±10% | Normal | Smith et al,20 2010 |
| Monthly change in BMI with no semaglutide or ESG | 0.0127 (0.0114 to 0.0140) | ±10% | Normal | Malhotra et al,21 2013 |
| Annual dropout rate (year 1) with semaglutide, % | 10 (6 to 14) | Trial data | Beta | Wilding et al,15 2021 (STEP 1 trial); Garvey et al,22 2022 (STEP 5 trial); O’Neil et al,23 2018 |
| Annual dropout rate (years 2-5) with semaglutide, % | 3.25 (1.95 to 4.55) | Trial data | Beta | O’Neil et al,23 2018; Marso et al,19 2016 |
| 30-d Mortality with ESG, % | 0.2 (0.1 to 0.3) | NA | Beta | Expert opinion |
| Annual rate of minor complications with ESG, % | 10 (6 to 14) | ±40% | Beta | Abu Dayyeh et al,17 2022 (MERIT) |
| Annual rate of major complications with ESG, % | 2 (1 to 3) | NA | Beta | Abu Dayyeh et al,17 2022 (MERIT) |
| Repeat procedure, ESG, % | 16 (13 to 19) | ±20% | Beta | Expert opinion |
| Quality-of-life estimates | ||||
| Class II obesity (aged 41-50 y) | 0.79 (-) | NA | Beta | Alsumali et al,24 2018 |
| Initial surgery | −0.22 (−0.24 to −0.20) | 1 wk Applied to ESG | Beta | Campbell et al,25 2010 |
| Minor complications | −0.11 (−0.12 to −0.10) | 2 wk Applied to ESG | Beta | Campbell et al,25 2010 |
| Major complications | −0.36 (−0.40 to −0.32) | 2 wk Applied to ESG | Beta | Campbell et al,25 2010 |
| Improvement per 1-unit decrease in BMI | 0.0056 (0 to 0.017) | NA | Beta | Klebanoff et al,26 2017 |
| Costs | ||||
| Initial surgery, ESG (2022), $ | 16 360 (12 270 to 20 450) | ±25% | Gamma | Institutional data |
| Annual cost, semaglutide (2022), $ | 13 618 (10 214 to 17 023) | ±25% | Gamma | ICER report,27 2022 |
| Major complications with ESG (2022), $ | 32 840 (24 630 to 41 050) | ±25% | Gamma | Campbell et al,25 2010 |
| Minor complications with ESG (2022), $ | 2676 (2007 to 3346) | ±25% | Gamma | Campbell et al,25 2010 |
Abbreviations: BMI, body mass index; ESG, endoscopic sleeve gastroplasty; ICER, Institute for Clinical and Economic Review; MERIT, Multicenter ESG Randomized Interventional Trial; NA, not applicable; STEP, Semaglutide Treatment Effect in People With Obesity.