The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
Sydney Health Economic, Sydney Local Health District, Camperdown, New South Wales, Australia.
Obesity (Silver Spring). 2018 Aug;26(8):1261-1269. doi: 10.1002/oby.22216.
This study aimed to assess population-level cost-effectiveness of the Weight Watchers (WW) program with doctor referral compared with standard care (SC) for Australian adults with overweight and obesity.
The target population was Australian adults ≥ 20 years old with BMI ≥ 27 kg/m , whose obesity status was subsequently modeled for 2015 to 2025. A microsimulation model (noncommunicable disease model [NCDMod]) was used to assess the incremental cost-effectiveness of WW compared with SC. A health system perspective was taken, and outcomes were measured by obesity cases averted in 2025, BMI units averted for 2015 to 2025, and quality-adjusted life years for 2015 to 2025. Univariate sensitivity testing was used to measure variations in the model parameters.
The WW intervention resulted in 60,445 averted cases of obesity in 2025 (2,311 more cases than for SC), extra intervention costs of A$219 million, and cost savings within the health system of A$17,248 million (A$82 million more than for SC) for 2015 to 2025 compared with doing nothing. The modeled WW had an incremental cost-effectiveness ratio of A$35,195 in savings per case of obesity averted in 2025. WW remained dominant over SC for the different scenarios in the sensitivity analysis.
The WW intervention represents good value for money. The WW intervention needs serious consideration in a national package of obesity health services.
本研究旨在评估有医生推荐的 Weight Watchers（WW）计划与标准护理（SC）相比，在治疗澳大利亚超重和肥胖成年人方面的人群成本效益。
目标人群为澳大利亚 20 岁及以上、BMI≥27kg/m 的成年人，其肥胖状况随后在 2015 年至 2025 年进行建模。使用微模拟模型（非传染性疾病模型[NCDMod]）来评估 WW 与 SC 相比的增量成本效益。采用卫生系统视角，通过 2025 年避免的肥胖病例、2015 年至 2025 年避免的 BMI 单位以及 2015 年至 2025 年的质量调整生命年来衡量结果。采用单变量敏感性测试来衡量模型参数的变化。
WW 干预在 2025 年可避免 60445 例肥胖病例（比 SC 多 2311 例），额外干预成本为 2.19 亿澳元，2015 年至 2025 年卫生系统节省 172.48 亿澳元（比 SC 多 8200 万澳元），与不采取任何措施相比。在 2025 年，每例肥胖病例节省 35195 澳元，这是 WW 的增量成本效益比。在敏感性分析的不同情景中，WW 仍然优于 SC。
WW 干预物超所值。WW 干预措施需要在国家肥胖健康服务方案中认真考虑。
