Cost-effectiveness analysis of <vagal nerve blocking for morbid obesity

Jeffrey C. Yu, Bruce Wolfe, Robert I. Griffiths, Raul Rosenthal, Daniel Cohen, Iris Lin

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To assess the lifetime cost-effectiveness of intermittent, reversible vagal nerve blocking (via the implantable weight loss device vBloc) therapy versus conventional therapy as treatment for patients who are class 2 obese with diabetes and for those who are class 3 obese with or without diabetes, who have found pharmacotherapy and behavioral therapies ineffective, but are not prepared or willing to undergo current bariatric surgical options.

STUDY DESIGN: A cost-effectiveness model was designed to simulate weight loss, diabetes remission, and costs in patients with obesity undergoing vagal nerve blocking therapy versus conventional therapy.

METHODS: The model compared 2 treatment arms, vagal nerve blocking therapy and conventional therapy, and for each treatment arm included 4 health states based on body mass index (BMI) class. Using Monte Carlo simulation, patients entered the model one at a time and could transition between health states by experiencing BMI change. The model focused on change in BMI and diabetes remission as predictors of healthcare costs, health-related quality of life, and survival. Inputs for vagal nerve blocking effectiveness were obtained from the ReCharge trial; however, remaining inputs were estimated from published literature. Incremental cost-effectiveness ratios (ICERs) were evaluated in terms of cost per quality-adjusted life-year (QALY) gained.

RESULTS: ICERs for vagal nerve blocking versus conventional therapy in patients who were class 2 and class 3 obese were estimated to be $17,274 and $21,713 per QALY gained, respectively. Sensitivity analyses showed results to be robust to reasonable variation in model inputs, with the upper limit of ICERs remaining below $30,000 for all sensitivity analysis scenarios assessed.

CONCLUSIONS: Vagal nerve blocking therapy provides a cost-effective alternative to conventional therapy in patients who are class 2 obese with diabetes and in those who are class 3 with or without diabetes.

Original languageEnglish (US)
Pages (from-to)e245-e252
JournalThe American journal of managed care
Volume23
Issue number8
Publication statusPublished - Aug 1 2017

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ASJC Scopus subject areas

  • Health Policy

Cite this

Yu, J. C., Wolfe, B., Griffiths, R. I., Rosenthal, R., Cohen, D., & Lin, I. (2017). Cost-effectiveness analysis of <vagal nerve blocking for morbid obesity. The American journal of managed care, 23(8), e245-e252.