Bariatric treatments for adult obesity - Institute of Health Economics

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INSTITUTE OF HEALTH ECONOMICSThe Institute of Health Economics (IHE) is an independent, not-for-profit organization thatperforms research in health economics and synthesizes evidence in health technology assessmentto assist health policy making and best medical practices.IHE BOARD OF DIRECTORSChairDr. Lorne Tyrrell – Chair, Institute of Health Economics, and Professor and CIHR/GSK Chairin Virology, University of AlbertaGovernment and Public AuthoritiesMs. Marcia Nelson – Deputy Minister, Alberta Health and WellnessMr. Bill Werry – Deputy Minister, Advanced Education & TechnologyDr. Jacques Magnan – President & CEO, Alberta Innovates – Health SolutionsDr. Chris Eagle – President and CEO, Alberta Health ServicesAcademiaDr. Renee Elio – Associate VP Research, University of AlbertaDr. Tom Feasby – Dean of Medicine, University of CalgaryDr. Verna Yiu – Professor & Interim Dean of Medicine & Dentistry, University of AlbertaDr. Christopher Doig – Professor & Head, Community Health Sciences, University of CalgaryDr. James Kehrer – Dean of Pharmacy, University of AlbertaDr. Herb Emery – Svare Chair, Health Economics, University of CalgaryDr. Doug West – Chair, Department of Economics, University of AlbertaIndustryMr. Terry McCool – Vice President, Corporate Affairs, Eli Lilly Canada Inc.Ms. Jennifer Chan – Vice President, Policy & Communications, Merck Frosst CanadaDr. Bernard Prigent – Vice President & Medical Director, Pfizer Canada Inc.Mr. Grant Perry – Vice-President, Public Affairs, GlaxoSmithKline Inc.Mr. William Charnetski –Vice President, Government Affairs, AstraZeneca Canada Inc.OtherMr. Doug Gilpin – Chair, Audit & Finance CommitteeExecutive Director & CEODr. Egon Jonsson – Institute of Health EconomicsBoard SecretaryMr. John Sproule – Senior Policy Director, Institute of Health Economics
Alberta STE ReportBariatric treatments for adultobesityAlberta STE Report: Policy-driven Health TechnologyAssessment reports that include an analysis of the social andsystem demographics, technological effectiveness and economicimplications of a health technology. The reports are writtenunder contract with the Alberta Health Technologies DecisionProcess and contextualized for use in Alberta.
Page 1: Alberta STE ReportBariatric treatme
Page 5 and 6: EXECUTIVE SUMMARYSocial and System
Page 7 and 8: Three surgical procedures—adjusta
Page 9: Costs of Bariatric Surgery and Pote
Page 12 and 13: Regulatory status .................
Page 14 and 15: TABLES AND FIGURESSection One: Soci
Page 16 and 17: ABBREVIATIONSAll abbreviations that
Page 18 and 19: LYMmMAMDMUHCNANHLBINHSNICENIHNNHNPH
Page 20 and 21: Bariatric physician: a licensed Doc
Page 22 and 23: High-density lipoprotein (HDL): a f
Page 24 and 25: Very-low-calorie diet (VLCD): a die
Page 26 and 27: Additional Internet searches were c
Page 28 and 29: This report addresses obesity in ad
Page 30 and 31: Many systemic factors have been ide
Page 32 and 33: Severe obesity is associated with d
Page 34 and 35: eport their height and under-report
Page 36 and 37: Also using self-reported data from
Page 38 and 39: An examination of overall obesity d
Page 40 and 41: Table S.2 presents the associationa
Page 42 and 43: • have multiple focal points and
Page 45 and 46: The main problem in any weight mana
Page 47: food, and a negative body image. As
Page 50 and 51: directly causes death. 61 To the ex
Page 52 and 53:
The addition of a selected pharmaco
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lack of formal training in nutritio
Page 56 and 57:
slightly more likely to have prescr
Page 58 and 59:
selection criteria, have facilities
Page 60 and 61:
Barriers to using appropriate baria
Page 62 and 63:
Overview of adult obesityOver the p
Page 64 and 65:
the need for regular physical activ
Page 66 and 67:
phenylpropanolamine/25. Sibutramine
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Complianceand AdherenceDemand andut
Page 70 and 71:
Aetna Clinical PolicyBulletinswww.a
Page 72 and 73:
Overweight 123,821 172,971 157,623
Page 74 and 75:
REFERENCES1. 2006 Canadian clinical
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34. Gostin LO. Fast and supersized:
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69. Klarenbach S, Padwal R, Wiebe N
Page 80 and 81:
105. Hill JO, Thompson H, Wyatt H.
Page 82 and 83:
141. Ross R, Bradshaw AJ. The futur
Page 84 and 85:
172. Arkinson J, Ji H, Fallah S, Pe
Page 86 and 87:
This section will address a set of
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dietary therapy is to reduce total
Page 90 and 91:
Additional benefits of exercise ove
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medications that inhibit intestinal
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Rimonabant may be considered for pa
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Long-term complications are specifi
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Devices used for bariatric surgeryH
Page 100 and 101:
Description of the Included Systema
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AEs for sibutramineAs compared to a
Page 104 and 105:
Evidence on Efficacy/EffectivenessW
Page 106 and 107:
Table T.7: Effects of behavioural t
Page 108 and 109:
SurgeryDescription of the included
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follow-up time was 3 years. Results
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group as compared to the VBG group.
Page 114 and 115:
The authors identified many methodo
Page 116 and 117:
The investigators pointed out that
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approximately 3 to 5 kilograms. For
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for studies with a mean age of part
Page 122 and 123:
Examining whether use of any of the
Page 124 and 125:
Evidence from placebo-controlled cl
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colorectal or gastroesophageal or f
Page 128 and 129:
Web of ScienceISI Interface License
Page 130 and 131:
AMA Clinical PracticeGuidelineswww.
Page 132 and 133:
critical appraisal of the included
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APPENDIX T.B: EXCLUDED STUDIESTable
Page 136 and 137:
Padwal R, Li SK, Lau DC. Long-term
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Quality subsection 1: At least MEDL
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Quality subsection 5a:Study quality
Page 142 and 143:
Partially reported: The study types
Page 144 and 145:
Table T.C.1: Results of quality ass
Page 146 and 147:
Table T.C.1: Results of quality ass
Page 148 and 149:
APPENDIX T.D: CHARACTERISTICS OF SY
Page 150 and 151:
Table T.D.1: Characteristics of the
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
APPENDIX T.E: EVIDENCE TABLE ON SAF
Page 158 and 159:
Serious surgical complicationsSurgi
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LSGmMAMDNAnssORQoLRCTRDRRRYGBSBPTGV
Page 162 and 163:
Table T.F.1-2: Weight loss - Behavi
Page 164 and 165:
Table T.F.1-4: Weight loss - Surger
Page 166 and 167:
Table T.F.2: Quality of life (QoL)
Page 168 and 169:
Curioni & Lourenco 2005 58Cholester
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Table T.F.3-3: Risk factors/comorbi
Page 172 and 173:
Table T.F.3-5: Long-term effects of
Page 174 and 175:
Maciejewski et al., 2005 65Avenell
Page 176 and 177:
Table T.G.2: Effects of bariatric s
Page 178 and 179:
Table T.G.4: Effects of bariatric s
Page 180 and 181:
18. Cerulli J, Lomaestro BM, Malone
Page 182 and 183:
50. Health Canada Drug Product Data
Page 184 and 185:
SECTION THREE: ECONOMIC EVALUATIONC
Page 186 and 187:
Definition of bariatric surgical pa
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etween surgical interventions, the
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concluded that adding orlistat to L
Page 192 and 193:
Weight management program (WMP) ver
Page 194 and 195:
groups. Compared with standard care
Page 196 and 197:
Results from Analysis of Provincial
Page 198 and 199:
DiscussionThe objectives of the eco
Page 200 and 201:
surgical suites, and so on. The bud
Page 202 and 203:
APPENDIX E.A: LITERATURE SEARCH SUM
Page 204 and 205:
CRD Databases(DARE, HTA & NHS EED)h
Page 206 and 207:
Web of ScienceISI Interface License
Page 208 and 209:
NEOS Librarywww.library.ualberta.ca
Page 210 and 211:
Table E.A.2: Evidence table of revi
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ResultHealth outcomesCostsMarginal
Page 214 and 215:
CostsMarginal analysisThe cost anal
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Time Horizon/discount rateCurrency/
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Objectivestudy perspective: society
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
S4Economic burden of obesityMean co
Page 226 and 227:
15. Lacey LA, Wolf A, O'shea D, Ern
Page 228 and 229:
Author Contribution StatementsPaula
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