Health Economic Assessment of High-Protein Diet Using High-Protein ONS for Weight Maintenance Following Weight Loss Using GLP-1RAs
Author(s)
Bjoern Schwander, BSc, MA, RN, PhD1, Kirk W. Kerr, PhD2, Dominique R. Williams, MD, MPH3, Suela Sulo, PhD4, W. Scott Butsch, MD5;
1AHEAD GmbH, Bietigheim-Bissingen, Germany, 2Abbott, Senior Manager, Columbus, OH, USA, 3Abbott, Columbus, OH, USA, 4Abbott, Abbott Park, IL, USA, 5Cleveland Clinic, Cleveland, OH, USA
1AHEAD GmbH, Bietigheim-Bissingen, Germany, 2Abbott, Senior Manager, Columbus, OH, USA, 3Abbott, Columbus, OH, USA, 4Abbott, Abbott Park, IL, USA, 5Cleveland Clinic, Cleveland, OH, USA
Presentation Documents
OBJECTIVES: Glucagon-like Peptide-1 Receptor Agonists (GLP-1RAs) have altered the landscape of obesity management by facilitating significant weight reduction that rivals bariatric surgery. However, discontinuation of GLP-1RAs is associated with significant weight regain.1 Weight cycling - intentionally losing and unintentionally regaining weight - can increase the risk of obesity-related diseases such as diabetes, heart disease, and cancer. This study models the health economic consequences of high-protein diet using high-protein ONS (HP-ONS) to prevent weight cycling in individuals using GLP-1RAs for treating obesity.
METHODS: A lifetime state-transition model (STM) with monthly cycles was developed to simulate a cohort of individuals with obesity, comparing individuals using a high-protein diet with HP-ONS for weight maintenance following GLP-1RA usage versus natural weight maintenance. Weight maintenance rates were drawn from existing RCTs, meta-analyses, and clinical expert input. Transition probabilities for obesity-associated diseases were informed by the literature and adjusted by BMI-related, weight-cycling-related, and T2D-related relative risks (RR). Key outcomes were the cost per obesity-associated event avoided, the cost per life-year (LY) gained, and the cost per quality-adjusted life year (QALY) gained, using a US societal perspective over a lifetime horizon. Sensitivity analyses investigated the robustness of the results.
RESULTS: Individuals using HP diet with HP-ONS had 0.0015 obesity-associated events avoided, 0.0102 LYs gained, 0.0152 QALYs gained and incremental cost of $369. The incremental cost-effective ratio (ICER) of $24,276 was below typical willingness to pay thresholds ($100,000-$150,000). Sensitivity analysis showed the model was most responsive to changes in patient age and the effectiveness of the intervention at promoting weight maintenance.
CONCLUSIONS: The model shows that a high-protein diet using HP-ONS is a cost-effective intervention for weight maintenance following weight loss with GLP-1RAs. Future research should investigate the long-term effects and health economic aspects of additional weight maintenance strategies.
METHODS: A lifetime state-transition model (STM) with monthly cycles was developed to simulate a cohort of individuals with obesity, comparing individuals using a high-protein diet with HP-ONS for weight maintenance following GLP-1RA usage versus natural weight maintenance. Weight maintenance rates were drawn from existing RCTs, meta-analyses, and clinical expert input. Transition probabilities for obesity-associated diseases were informed by the literature and adjusted by BMI-related, weight-cycling-related, and T2D-related relative risks (RR). Key outcomes were the cost per obesity-associated event avoided, the cost per life-year (LY) gained, and the cost per quality-adjusted life year (QALY) gained, using a US societal perspective over a lifetime horizon. Sensitivity analyses investigated the robustness of the results.
RESULTS: Individuals using HP diet with HP-ONS had 0.0015 obesity-associated events avoided, 0.0102 LYs gained, 0.0152 QALYs gained and incremental cost of $369. The incremental cost-effective ratio (ICER) of $24,276 was below typical willingness to pay thresholds ($100,000-$150,000). Sensitivity analysis showed the model was most responsive to changes in patient age and the effectiveness of the intervention at promoting weight maintenance.
CONCLUSIONS: The model shows that a high-protein diet using HP-ONS is a cost-effective intervention for weight maintenance following weight loss with GLP-1RAs. Future research should investigate the long-term effects and health economic aspects of additional weight maintenance strategies.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE269
Topic
Economic Evaluation
Disease
STA: Nutrition