Wednesday, February 25, 2015

Bariatric Embolization

Ghrelin is a hormone found mainly in the stomach. Ghrelin is known as the hunger hormone. It is believed that ghrelin tells our brain that we are hungry. Some forms of bariatric surgery cause a decrease in ghrelin, which reduces the desire to eat. In fact, sleeve gastrectomy, which is considered to be an effective weight loss surgery, achieves a large part of its success by removing about 85% or the stomach, where much of the ghrelin in our body is found. So reducing the ghrelin or the effect of ghrelin might lead to weight loss. Methods, other than bariatric surgery, that may eliminate or reduce ghrelin include diet and a bariatric procedure called bariatric embolization.

Researchers have found that following a diet containing healthy carbohydrates such as whole grains, and getting enough sleep, might decrease the ghrelin in our body. And a minimally invasive method that may reduce the effects of ghrelin is embolization--specifically bariatric embolization.

Bariatric embolization is where certain blood vessels to the stomach are blocked to decrease the ghrelin. In the procedure, a small catheter is inserted in the left gastric artery via the wrist or the groin. This artery supplies the upper part of the stomach. Tiny particles are then injected into the artery to block the flow of blood, and decrease the amount of ghrelin singling the brain.

Although bariatric embolization has not been proven for humans, animal studies at John's Hopkins University and Duke University showed impressive weight loss and ghrelin reduction in animal studies. And researchers at Harvard found that blocking the gastric artery to stop bleeding also caused patients to lose weight. So, bariatric embolization may one day be a tool for weight loss. And weight loss practitioners might want to monitor this research so they can be prepared to take advantage of the weight loss tool if and when it materializes. 

Thursday, February 19, 2015

For the Time Being, Qsymia May Be the Leading Weight Loss Drug

There are currently five drugs on the US market that are available for long-term weight loss. These drugs are Xenical (and its over-the-counter version Alli), Belviq, Contrave,  Saxena, and Qsymia. Contrave and Saxena received FDA approval during the last half of 2014, while Qsymia, Belviq and Xenical have been on the market for more than two years. At the moment, Qsymia may have the upper hand in the market.

In one study, Qsymia was found to be a cost-effective weigh loss approach. A well known measuring tool was used in the study. The measurement used in the cost-effectiveness assessment is the QALY. QALY is defined as quality-adjusted life-year. The QALY measures the effectiveness of a medical treatment "in terms of quality-adjusted life years gained. "Costs included the prescription cost, medication cost offsets and physician appointment costs."

Using the costs of the treatment and the QALY measure, experts can determine the cost-effectiveness or the cost per QALY of a medical treatment. Healthcare economists use $50,000 as the threshold cost for a QALY. They desire the cost per QALY of a treatments to be less than $50,000 for the treatment to be deemed cost effective. And in the above mentioned study, Qsymia's QALY cost was below the $50,000 threshold at $48,340 .

Also, investment analysts believe that Qsymia currently occupies the best position in the market, because Qsymia has slightly better insurance coverage than other obesity drugs.  According to the analysts, "In 2014, Qsymia ... enjoyed a slightly better position in terms of insurance coverage [than its competitors]." This bodes well for Qsymia, at least for now. And its position in the market along with its cost effectiveness may induce more physicians to prescribe the drug.

Of course, time will tell if Qsymia can continue to be the leader in the obesity drug arena. When the other obesity drugs are subjected to a QALY-type analysis, one of them might be more cost effective.
Subscribe to Weight Loss or Bariatric Industry Strategy Blog by Email