Bariatric treatments for adult obesity - Institute of Health Economics

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Aetna Clinical PolicyBulletinswww.aetna.com/about/cov_det_policies.htmMHRAwww.mhra.gov.uk/index.htmAmerican Society ofBariatric Physicianswww.asbp.org/AETMISwww.aetmis.gouv.qc.caCADTHwww.cadth.caInstitute for Clinical andEvaluative Sciences(ICES) www.ices.on.ca/Health TechnologyAssessment Unitat McGillwww.mcgill.ca/tau/Medical AdvisorySecretariatwww.health.gov.on.ca/english/providers/program/mas/mas_mn.htmlBlueCross BlueShieldTechnology EvaluationCenterAMA Clinical PracticeGuidelineswww.topalbertadoctors.org/informed_practice/clinical_practice_guidelines.htmlCMA Infobasehttp://mdm.ca/cpgsnew/cpgs/index.aspNational GuidelineClearinghousewww.ngc.govNICE Guidancehttp://guidance.nice.org.uk/4 June 2010 Obesity; bariatrics4 June 2010 Obesity; bariatrics(1 sibutramine safety warning)4 June 2010 About ASBP> Bariatric Practice Guidelines(found 1 document)HTA Agencies4 June 2010 Browsed list of publications, 2000–2010(0 results)4 June 2010 Obesity; bariatric; weight loss4 June 2010 Bariatric; bariatrics; obesity; LAGB4 June 2010 Browsed list of publications (2002–2009)4 June 2010 Browsed publication list (2001–2010) (also checked rapid review list)(1 publication on LAGB safety;1 publication on bariatric surgery (has economic analysis))4 June 2010 Browsed publication list(LAGB publication)18 May 2010 No obesity guidelines18 May 2010 Obesity, bariatric18 May 2010 Keyword: obesity or bariatricAge Range: Adult (19 to 44 years), Middle Age (45 to 64 years)Publication Date(s): 2010, 2009, 2008, 2007, 2006, 2005(16 relevant results)18 May 2010 Obesity, bariatric(an enormous guideline)Note: ††“*”, “#”, and “?” are truncation characters that retrieve all possible suffix variations of the root word, e.g., surg*retrieves surgery, surgical, surgeon, etc.Bariatric treatments for adult obesity 46
APPENDIX S.B: PREVALENCE OF ADULT OBESITY IN ALBERTA IN 2007By sexBMI Male Female Total (%)**Missing data 39,016 99,885 138,902 (5.30)Underweight 9,994 47,802 57,796 (2.21)Normal weight 495,807 620,423 1,116,229 (42.62)Overweight 521,074 321,809 842,883 (32.18)Obese class I 194,740 132,602 327,342 (12.50)Obese class II 47,999 49,190 97,190 (3.71)Obese class III 14,708 23,983 38,691 (1.48)Total 1,323,338 1,295,694 2,619,033%* 19.45% 15.88% 17.69%By age (years)BMI 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65+ TotalMissing data 17,781 35,188 22,154 20,956 9,491 33,333 138,902Underweight 14,257 12,717 11,257 7,659 5,986 5,919 57,796Normal weight 218,045 242,277 217,726 200,066 119,506 118,609 1,116,229Overweight 80,047 161,858 165,716 195,269 120,632 119,360 842,883Obese class I 19,780 63,166 64,752 75,562 56,317 47,765 327,342Obese class II 7,564 18,948 17,925 26,045 15,605 11,102 97,190Obese class III 1,863 7,426 8,128 9,684 6,567 5,023 38,691Total 359,337 541,580 507,658 535,241 334,104 341,111 2,619,033% 8.13% 16.53% 17.89% 20.79% 23.49% 18.73% 17.69%By educationBMI Less than High school Missing TotalMissing data 25,415 102,966 10,520 138,902Underweight 5,822 49,235 2,739 57,796Normal weight 117,450 975,855 22,924 1,116,229Overweight 105,629 721,656 15,598 842,883Obese class I 47,465 274,312 5,566 327,342Obese class II 21,763 74,302 1,124 97,190Obese class III 4,498 34,193 0 38,691Total 328,042 2,232,519 58,471 2,619,033% 22.47% 17.15% 11.44% 17.69%By income ($ thousands)BMI 80 Missing TotalMissing data 43,255 30,988 16,315 6,752 5,544 36,049 138,902Underweight 14,704 10,633 10,701 4,888 3,543 13,327 57,796Normal weight 250,270 228,250 198,063 114,633 131,414 193,600 1,116,229Bariatric treatments for adult obesity 47
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Alberta STE ReportBariatric treatme
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Alberta STE ReportBariatric treatme
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EXECUTIVE SUMMARYSocial and System
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Three surgical procedures—adjusta
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Costs of Bariatric Surgery and Pote
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Regulatory status .................
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TABLES AND FIGURESSection One: Soci
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ABBREVIATIONSAll abbreviations that
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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
Page 54 and 55: 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
Page 68 and 69: Complianceand AdherenceDemand andut
Page 72 and 73: Overweight 123,821 172,971 157,623
Page 74 and 75: REFERENCES1. 2006 Canadian clinical
Page 76 and 77: 34. Gostin LO. Fast and supersized:
Page 78 and 79: 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
Page 88 and 89: dietary therapy is to reduce total
Page 90 and 91: Additional benefits of exercise ove
Page 92 and 93: medications that inhibit intestinal
Page 94 and 95: Rimonabant may be considered for pa
Page 96 and 97: Long-term complications are specifi
Page 98 and 99: Devices used for bariatric surgeryH
Page 100 and 101: Description of the Included Systema
Page 102 and 103: 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
Page 110 and 111: follow-up time was 3 years. Results
Page 112 and 113: 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
Page 118 and 119: approximately 3 to 5 kilograms. For
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for studies with a mean age of part
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Examining whether use of any of the
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Evidence from placebo-controlled cl
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colorectal or gastroesophageal or f
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Web of ScienceISI Interface License
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AMA Clinical PracticeGuidelineswww.
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critical appraisal of the included
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APPENDIX T.B: EXCLUDED STUDIESTable
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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
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Partially reported: The study types
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Table T.C.1: Results of quality ass
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Table T.C.1: Results of quality ass
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APPENDIX T.D: CHARACTERISTICS OF SY
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Table T.D.1: Characteristics of the
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APPENDIX T.E: EVIDENCE TABLE ON SAF
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Serious surgical complicationsSurgi
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LSGmMAMDNAnssORQoLRCTRDRRRYGBSBPTGV
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Table T.F.1-2: Weight loss - Behavi
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Table T.F.1-4: Weight loss - Surger
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Table T.F.2: Quality of life (QoL)
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Curioni & Lourenco 2005 58Cholester
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Table T.F.3-3: Risk factors/comorbi
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Table T.F.3-5: Long-term effects of
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Maciejewski et al., 2005 65Avenell
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Table T.G.2: Effects of bariatric s
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Table T.G.4: Effects of bariatric s
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18. Cerulli J, Lomaestro BM, Malone
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50. Health Canada Drug Product Data
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SECTION THREE: ECONOMIC EVALUATIONC
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Definition of bariatric surgical pa
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etween surgical interventions, the
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concluded that adding orlistat to L
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Weight management program (WMP) ver
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groups. Compared with standard care
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Results from Analysis of Provincial
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DiscussionThe objectives of the eco
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surgical suites, and so on. The bud
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APPENDIX E.A: LITERATURE SEARCH SUM
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CRD Databases(DARE, HTA & NHS EED)h
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Web of ScienceISI Interface License
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NEOS Librarywww.library.ualberta.ca
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Table E.A.2: Evidence table of revi
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ResultHealth outcomesCostsMarginal
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CostsMarginal analysisThe cost anal
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Time Horizon/discount rateCurrency/
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Objectivestudy perspective: society
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S4Economic burden of obesityMean co
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15. Lacey LA, Wolf A, O'shea D, Ern
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Author Contribution StatementsPaula
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