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Cost-Effectiveness Analysis of Vagal Nerve Blocking for Morbid Obesity
Jeffrey C. Yu, AB; Bruce Wolfe, MD; Robert I. Griffiths, ScD, MS; Raul Rosenthal, MD; Daniel Cohen, MA; and Iris Lin, PhD
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Cost-Effectiveness Analysis of Vagal Nerve Blocking for Morbid Obesity

Jeffrey C. Yu, AB; Bruce Wolfe, MD; Robert I. Griffiths, ScD, MS; Raul Rosenthal, MD; Daniel Cohen, MA; and Iris Lin, PhD
This lifetime economic analysis demonstrates vagal nerve blocking therapy to be a cost-effective alternative to conventional therapy in class 2 and 3 obesity patients.
This analysis provides a cost-effectiveness evaluation of a new weight loss therapy that may present an affordable and minimally invasive option for patients seeking alternatives to currently available weight loss treatments. Recent cost-effectiveness analyses in bariatric surgery have compared bariatric surgical options such as LAGB and LRYGB versus no treatment.22,29 The designs of these previous models have informed this model’s design for capturing the impact of BMI class and diabetes remission on costs, clinical outcomes, and cost-effectiveness.

Our findings suggest that vagal nerve blocking therapy is likely to be a cost-effective alternative to conventional therapy among class 2 patients with diabetes and class 3 patients with or without diabetes. ICERs from base-case and sensitivity analyses fell below $30,000 per QALY gained, suggesting that vagal nerve blocking therapy represents good value for money from a US payer perspective. 

Author Affiliations: Boston Health Economics, Inc (JCY, RIG, IL), Waltham, MA; Oregon Health & Science University (BW), Portland, OR; Cleveland Clinic Florida (RR), Weston, FL; EnteroMedics, Inc (DC), St. Paul, MN.

Source of Funding: This study was funded by EnteroMedics, Inc.

Author Disclosures: Mr Yu and Dr Lin are employees of, and Dr Griffiths is a consultant to, Boston Health Economics, Inc, which consulted for EnteroMedics, Inc. Mr Cohen is employed by, and owns stock in, EnteroMedics. Dr Wolf received a contract from EnteroMedics to conduct the ReCharge study. The remaining authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (JCY, RIG, DC, IL); acquisition of data (JCY); analysis and interpretation of data (JCY, RIG, DC, IL); drafting of the manuscript (JCY, BW, RIG, RR, DC, IL); critical revision of the manuscript for important intellectual content (JCY, BW, RIG, RR, DC, IL); statistical analysis (JCY, RIG, IL); provision of patients or study materials (DC); obtaining funding (DC); administrative, technical, or logistic support (JCY); and supervision (JCY, BW, RIG, RR, IL).

Address Correspondence to: Iris Lin, PhD, Boston Health Economics, 20 Fox Rd, Waltham, MA 02451. E-mail: iris.lin@bhei.com. 
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