A health economic model to assess the cost-effectiveness of OPTIFAST for the treatment of obesity in the United States

Objectives: Obesity is associated with high direct medical costs and indirect costs resulting from productivity loss. The high prevalence of obesity generates a justified need to identify cost-effective weight loss approaches from a payer’s perspective. Within the variety of weight management techniques, OPTIFAST is a clinically recognized and scientifically proven total meal replacement Low Calorie Diet that provides meaningful results in terms of weight loss and reduction in comorbidities. The objective of this study is assess potential cost-savings of the OPTIFAST program in the US, as compared to “no intervention” and pharmacotherapy.

Methods: An event-driven decision analytic model was used to estimate payer’s cost-savings from reimbursement of the 1-year OPTIFAST program over 3 years in the US. The analysis was performed for the broad population of obese persons (BMI >30?kg/m²) undergoing the OPTIFAST program vs liraglutide 3?mg, naltrexone/bupropion and vs “no intervention”. The model included the risk of complications related to increased BMI. Data sources included published literature, clinical trials, official US price/tariff lists, and national population statistics. The primary perspective was that of a US payer; costs were provided in 2016?US dollars.

Results: OPTIFAST leads over a period of 3 years to cost-savings of USD 9,285 per class I and II obese patient (BMI 30–39.9?kg/m²) as compared to liraglutide and USD 685 as compared to naltrexone/bupropion. In the same time perspective, the OPTIFAST program leads to a reduction of cost of obesity complications of USD 1,951 as compared to “no intervention”, with the incremental cost-effectiveness ratio of USD 6,475 per QALY. Scenario analyses also show substantial cost-savings in patients with class III obesity (BMI?≥?40.0?kg/m²) and patients with obesity (BMI?=?30–39.9?kg/m²) and type 2 diabetes vs all three previous comparators and bariatric surgery.

Conclusions: Reimbursing OPTIFAST leads to meaningful cost-savings for US payers as compared with “no intervention” and liraglutide and naltrexone/bupropion in obese patients. Similar results can be expected in matching healthcare settings of other countries. Moreover, OPTIFAST has additional clinical and economic advantages through very low complication and adverse events rates.     

Assessment of model uncertainty in destinations and travel forecasts of models of complex spatial shopping behaviour

This paper reports the results of an analysis of model uncertainty in the context of shopping behaviour. This analysis is positioned in a discussion on the evolution of models of spatial shopping behaviour. For different generations of shopping models, the potential of uncertainty analysis is discussed. The actual analysis is based on an application of the Albatross model to the city of Rotterdam, The Netherlands. Characteristic of this model is that shopping trips are embedded in the prediction of daily more comprehensive activity-travel patterns, adding complexity and realism to traditional models of spatial shopping behaviour, such as the Huff and spatial interaction model. Results show that overall the uncertainty associated with the aggregate outcomes of the model is small. It is higher for the total number of visits to selected shopping areas.     

Colourful practice: Is design education informing architects’ use of colour?

This paper sets out to consider the relationship between design education, architects’ colour knowledge, colour orientations and colour use in design practice. Specifically, a survey of 274 architects, architectural academics and postgraduates in Australia and Iran addressed the questions—is design education informing colour knowledge, and does colour education and knowledge inform an architect’s colour use in their designs? The findings suggest colour use in architecture has two chief influences: (1) Colour Orientation (architects’ general attitudes and prejudices towards colour use); and (2) Contextual Variables (the cultural and physical context of designs). The study shows that while the amount of colour education that architects receive has little role in informing their colourfulness orientations (i.e., how colourful they believe architecture in general should be), the greater an architect’s colour knowledge the more colourful their designs will be. The study suggests that the colourfulness of contemporary buildings is likely influenced more by levels of architects’ theoretical colour knowledge and by their personal preferences rather than by contextual influences such as the cultural and physical context of a design, the building function, or client directives.     

Using Virtual Reality to Enhance Food Technology Education

International Journal of Technology and Design Education - The use of Virtual Reality (VR) technology combined with 360-degree images and videos provide an opportunity for teachers to bring...