It is estimated that more than one-third of American adults and about 17% of adolescents are obese. The health effects of obesity are myriad and include the development of type 2 diabetes, hypertension, cardiovascular disease, cancer, high blood pressure, and sleep apnea. Obesity and its sequelae are estimated to generate $147 billion in health care costs in the US alone. The complexity involved in managing obesity may affect both patient candidacy for certain treatment options as well as adherence to lifestyle changes necessary to sustain weight loss and improve health outcomes. Clinical interest is therefore high in treatments that may be used for patients at multiple levels of obesity, as well as in interventions that promote better adherence to lifestyle change.
Interventions of interest:
• Temporary intragastric balloon systems (e.g., Silimed®, ReShape®)
• Vagus nerve block devices (e.g., Maestro® system)
• Duodenal-jejunal bypass liner (EndoBarrier®)
• Naltrexone/bupropion sustained-release (Contrave®)
• Phentermine/topiramate extended-release (Qsymia®)
• Lorcaserin (Belviq®)
• Liraglutide (Saxenda®)
Date of review: May 2015
Intervention of interest:
Roux-en-Y gastric bypass (RYGB)
Biliopancreatic diversion/duodenal switch (BPD/DS)
Laparoscopic adjustable gastric banding (LAGB)
Vertical sleeve gastrectomy (VSG)
Date of review: April 2015
ASSOCIATED MEETING & MATERIALS
Location: The California Endowment, 1000 N. Alameda St., Los Angeles, CA 90012
The California Technology Assessment Forum (CTAF) held a public meeting on Tuesday, July 14, 2015 to discuss the comparative effectiveness and value of several current approaches to manage obesity, including medications, devices, and surgical procedures. ICER produced a report that includes a systematic review of the published evidence, as well as an economic analysis that examines cost-effectiveness and budget impact of the various approaches. The report formed the basis for deliberation and discussion at the public meeting, where the CTAF panel voted on key questions raised in the report, and a policy roundtable discussed evidence-based practice and policy recommendations.
Public comments received on the Draft Evidence Report.