Monday, May 18, 2015

Primary Care Physicians and Commercial Weight Loss Providers as Partners

When healthcare providers are considering weight loss methods, they usually concentrate on safety and efficacy. But there is another important consideration. It is the cost of the treatment. Because, even if the  treatment is safe and effective, but not affordable, many people who need the treatment won't get it. The Affordable Care Act mandates that insurers cover counseling for obesity. And some insurers will cover weight loss drugs. Still, weight loss affordability is a problem for many. For primary care physicians who are concerned with weight- loss-program affordability for their patients, partnering  with commercial weight loss providers may be a way to make weight loss more affordable.

Medical economists look at the cost-effectiveness of different kinds of weight loss treatments. Some of these economists use something called the QALY to evaluate the cost effectiveness of a medical treatment. The QALY is defined as a "quality adjusted life year." Researchers look at the "cost per QALY gained" with a treatment to assess the cost effectiveness of the treatment.

Although controversial, some medical economists use $50,000 as the threshold cost per QALY dollar amount. If the cost per QALY is less than $50,000, the given treatment is considered cost effective. If the cost per QALY is greater than $50,000, the treatment could be rejected. And one study showed that the Weight Watchers commercial weight loss program to be the most cost effective program at $34,630.   

Researchers in England have investigated the cost effectiveness of referrals by General Practitioners to commercial weight loss providers. After one year of referrals to commercial weight loss providers, one group of English researchers concluded that the cost per QALY was $10237.83.  This is well below $50,000.

Another group of English researchers concluded that referred-commercial-program "participants view the lifestyle-based, non-medical commercial programme as an appropriate intervention for weight management." Further, program participants "frame their experience of the intervention as medically pertinent with clear health benefits."

Therefore, we may conclude that in some cases, it could be beneficial to the primary care physician and his or her overweight patients to partner with a commercial weight loss provider. This could be a safe, effective, and affordable approach for some patients. 


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