Can responsive deep brain stimulation be a cost-effective treatment for severe obesity?
Obesity (Silver Spring)
; 30(2): 338-346, 2022 02.
Article
in English
| MEDLINE | ID: covidwho-1750426
ABSTRACT
OBJECTIVE:
A first-in-human responsive deep brain stimulation (rDBS) trial (NCT03868670) for obesity is under way, which is based on promising preclinical evidence. Given the upfront costs of rDBS, it is prudent to examine the success threshold for cost-effectiveness compared with laparoscopic Roux-en-Y gastric bypass (LRYGB).METHODS:
Efficacy and safety data on LRYGB and safety data on rDBS were collected for established indications through a literature search. The success threshold was defined as minimum BMI reduction. Treatment costs were calculated via Medicare national reimbursement data.RESULTS:
LRYGB had a mean BMI reduction of 13.75 kg/m2 . Based on adverse events, LRYGB was a less-preferred health state (overall adverse event utility of 0.96 [0.02]) than rDBS (0.98 [0.01]), but LRYGB ($14,366 [$6,410]) had a significantly lower treatment cost than rDBS ($29,951 [$4,490]; p < 0.0001). Therefore, for rDBS to be cost-effective compared with LRYGB, the multiple models yielded a success threshold range of 13.7 to 15.2 kg/m2 .CONCLUSIONS:
This study established a preliminary efficacy success threshold for rDBS to be cost-effective for severe obesity, and results from randomized controlled trials are needed. This analysis allows for interpretation of the economic impact of advancing rDBS for obesity in light of ongoing trial results and suggests an attainable threshold is needed for cost-effectiveness.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Obesity, Morbid
/
Gastric Bypass
/
Deep Brain Stimulation
Type of study:
Experimental Studies
/
Prognostic study
/
Randomized controlled trials
Limits:
Aged
/
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Obesity (Silver Spring)
Journal subject:
Nutritional Sciences
/
Physiology
/
Metabolism
Year:
2022
Document Type:
Article
Affiliation country:
Oby.23324
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