Utility Decrements Associated with Adult Overweight and Obesity in Australia: A Systematic Review and Meta-Analysis

• Published in: PharmacoEconomics 2021-05, Vol.39 (5), p.503-519
• Main Authors: Carrello, Joseph, Hayes, Alison, Killedar, Anagha, Von Huben, Amy, Baur, Louise A., Petrou, Stavros, Lung, Thomas
• Format: Article
• Language: English
• Subjects: Adults; Analysis; Body mass index; Complications and side effects; Cost analysis; Diabetes; Economic aspects; Forecasts and trends; Health Administration; Health aspects; Health care; Health Economics; Health status indicators; Health technology assessment; Medical economics; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Meta-analysis; Obesity; Overweight; Pharmacoeconomics and Health Outcomes; Population; Preferences; Public Health; Quality of life; Quality of Life Research; Systematic Review
• ISSN: 1170-7690; 1179-2027
• DOI: 10.1007/s40273-021-01004-x

Objective The aim was to conduct a systematic review and meta-analysis of health state utility decrements associated with overweight and obesity in adults 18 years and over, for use in modelled economic evaluations in Australia. Methods A systematic review was conducted in nine databases to identify studies that reported health state utility values by weight status. Random-effects meta-analysis was used to synthesise average utility decrements (from healthy weight) associated with overweight, all obesity and obesity classes 1, 2 and 3. Heterogeneity surrounding utility decrements was assessed via sub-group analysis, random-effects meta-regression and sensitivity analyses. Results Twelve studies were found for which data were used to synthesise utility decrements, estimated as overweight = 0.020 (95% confidence interval 0.010–0.030), all obesity = 0.055 (0.034–0.076), obesity class 1 = 0.047 (0.017–0.077), class 2 = 0.072 (0.028–0.116) and class 3 = 0.084 (0.039–0.130). There was considerable heterogeneity in our results, which could be accounted for by the different ages and utility instruments used in the contributing studies. Conclusions Our results demonstrate that elevated weight status is associated with small but statistically significant reductions in utility compared with healthy weight, which will result in reduced quality-adjusted life years when extrapolated across time and used in economic evaluations.