Cost-effectiveness analysis of duodenal-jejunal bypass sleeve device for people with obesity.

IF 2.7 3区经济学 Q1 ECONOMICS

Health Economics Review Pub Date : 2025-04-08 DOI:10.1186/s13561-025-00623-w

Qian Xu, Wei Yan, Luo Li, Bao Liu

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引用次数: 0

Abstract

Background: Obesity has become major public health problem around the world. Lifestyle interventions, Pharmacotherapy and bariatric surgery are the common intervention to reduce weight in clinical practice. This study aims to conduct an economic evaluation of Duodenal-Jejunal Bypass Sleeve (DJBS) plus Intensive Lifestyle Intervention (ILI) compared with ILI only in people with obesity in China.

Methods: A hybrid model using a Decision Tree and Markov model was used to compare 9-month and lifetime horizon cost-effectiveness between DJBS plus ILI and ILI only. The data on clinical effectiveness were based on a prospective, open-label, and randomized trial (NCT05938231). This study employed 1-3 times the Gross Domestic Product (GDP) per capita (¥85,498, exchange rate: $1 US dollar = ¥6.73, 2022) and disposable income per capita (¥36,883, 2022) as the Willingness-To-Pay (WTP) thresholds. One-way, probabilistic sensitivity and scenario analysis were performed to test the robustness of the results.

Results: The results of the 9-month decision tree model showed that compared to ILI only, DJBS plus ILI decreased body mass index (BMI) by 1.69 kg/m2 (1.41 vs. 3.10), with an increasing cost of ¥28,963.98 yuan (¥29,111.06 vs.¥147.08). The incremental cost-effectiveness ratio (ICER) was ¥17,138.45 per unit decrease of BMI. The lifetime horizon model showed that compared to ILI only, DJBS plus ILI had a higher cost of ¥13261.94 yuan (¥31,688.98 vs. ¥18,427.04), while with a life-year increase of 0.02 (9.43 vs. 9.41) and quality-adjusted life years (QALYs) increase of 0.15 (7.82 vs. 7.67) per people with obesity. The ICER was ¥88,412.93 per QALY gained. Probability sensitivity analysis showed the robustness of the economic evaluation results.

Conclusion: The findings suggested that DJBS plus ILI was not a cost-effective strategy over a lifetime horizon when the WTP threshold was set at GDP per capita and disposable income per capita. However, it was considered cost-effective when the threshold was set at 1.03 times GDP per capita.

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肥胖症患者十二指肠-空肠旁路套筒装置的成本-效果分析。

背景：肥胖已成为全球主要的公共卫生问题。生活方式干预、药物治疗和减肥手术是临床上常见的减肥干预措施。本研究旨在对中国肥胖人群采用十二指肠空肠旁路套管（DJBS）加强化生活方式干预（ILI）与仅采用ILI进行经济评价。方法：采用决策树和马尔可夫模型的混合模型，比较DJBS加ILI和仅ILI的9个月和终身成本效益。临床疗效数据基于一项前瞻性、开放标签、随机试验（NCT05938231）。本研究采用人均国内生产总值（GDP）（85,498日元，汇率：1美元= 6.73日元，2022）和人均可支配收入（36,883日元，2022）的1-3倍作为支付意愿（WTP）阈值。采用单向、概率敏感性和情景分析来检验结果的稳健性。结果：9个月决策树模型结果显示，与单纯ILI相比，DJBS加ILI使体重指数（BMI）降低1.69 kg/m2 (1.41 vs. 3.10)，成本增加28,963.98元（29,111.06 vs. 147.08）。每单位BMI降低的增量成本-效果比（ICER）为17138.45元。生命水平模型显示，与单纯ILI相比，DJBS加ILI的成本为13261.94元（31,688.98元对18,427.04元），肥胖人均生命年增加0.02元（9.43元对9.41元），质量调整生命年（QALYs）增加0.15元（7.82元对7.67元）。该指数为每升88,412.93日元。概率敏感性分析显示了经济评价结果的稳健性。结论：研究结果表明，当WTP阈值设定为人均GDP和人均可支配收入时，DJBS + ILI不是一种具有成本效益的终身策略。然而，当门槛设定为人均GDP的1.03倍时，它被认为是具有成本效益的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Economics Review Multiple-

CiteScore

3.90

自引率

4.20%

发文量

审稿时长

13 weeks

期刊介绍： Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.