Background
A large portion of health care expenditure is spent on pharmaceutical drugs. Expenditure on these medicines has increased both in absolute terms, and as a proportion of total health expenditure. No previous studies have investigated the prescribing costs by general practitioners when seeing patients during a weight loss intervention.
Methods
This study evaluated the medication costs by individual class during a 1 year study in which 268 participants were randomised to one of two weight loss programmes, either standard care (SC) as defined by national guidelines or a commercial provider (Weight Watchers) (CP).
Results
Baseline BMI of participants (mean ± standard deviation (SD)) was 32.0 ± 2.5 kg/m2, body weight was 87.5 ± 11.8 kg, and age was 47.4 ± 11.7 years. A small number (7%) of participants were diagnosed with type 2 diabetes mellitus at study commencement. SC participants spent more on medications than the CP group with no better weight or metabolic outcomes over the 1 year study. For both groups the highest proportion of prescriptions (≥ 30% of medications) was for indications related to cardiovascular disease.
Conclusion
Primary care providers may not be in the best position to provide weight loss advice and a shared care approach with efficacious and cost-effective interventions may be more logical. This study indicates that obesity treatment via a shared care approach with a commercial programme results in less use of medication, better clinical outcomes and hence lower health costs overall.
Funding
This study was investigator-initiated but funded by Weight Watchers International through a grant to the Medical Research Council (UK). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.