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Approved research

Health economics of obesity

Principal Investigator: Dr Seamus Kent
Approved Research ID: 36623
Approval date: May 10th 2018

Lay summary

Clinical trials are used to reliably estimate weight loss from weight management treatments. Decisions about whether to provide such treatments on the NHS require decision models to estimate the long-term health impacts and value for money (i.e. cost-effectiveness) of such treatments. These models have limitations. First, their predictive accuracy has not been well tested. Second, the models are not typically appropriate for evaluating treatments targeted at people with long-term conditions. Third, evidence on the costs of obesity-related conditions is limited. Better and well-tested models would allow for better and more transparent decision-making, which could ultimately improve population health. This project consists of three phases, with a total duration of three years. Phase 1 (2018-2019, duration 2 years) We will use UK Biobank data to estimate the relationship of measures of body size and fat with the use and costs of hospital admissions, primary care consultations, prescription medications, and diagnostic and monitoring tests, overall and for different health conditions. We will explore how this relationship differs by gender, age, ethnicity, deprivation, and health-related behaviours like smoking and physical activity. Such information is useful to healthcare policy makers, planners, and commissioners. Phase 2 (2019, duration 1 year) The PRIMEtime model is a widely used chronic disease policy model that estimates the long-term effectiveness and cost-effectiveness of weight management treatments. It predicts the occurrence of weight-related conditions like type-2 diabetes, heart disease, stroke, and several cancers, as well as mortality and healthcare costs over time in the UK population. These predictions, and potentially those from other models, will be compared to data from the UK Biobank to assess their accuracy and usefulness. Phase 3 (2019 onwards, duration 2 years) Based on the results of the first two phases we will first update and extend the PRIMEtime model. This could include updating evidence on disease occurrence and mortality or costs, or adding additional weight-related health conditions like osteoarthritis. This work will also inform the value of developing a new model based on Biobank data which would allow estimation of cost-effectiveness in different populations including those with long-term conditions like type-2 diabetes, in line with the research priorities of the NHS.