{'fraction_non_alphanumeric': 0.02087611225188227, 'fraction_numerical': 0.0023956194387405884, 'mean_word_length': 5.568539325842696, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Cost-Utility Analyses of Interventions to Prevent and Treat Obesity

Obesity is a serious risk factor for many chronic diseases. It is also quite an expensive one, generating direct health service costs of approximately NIS 1.14 billion, which is equivalent to 0.16% of Israel's Gross Domestic Product – or 2% of the country's health expenditure. The objective of the study was to assist Israeli policymakers in their efforts to prioritize interventions to prevent and treat obesity in Israel by calculating cost-effectiveness ratios of relevant interventional modalities. Cost-utility ratios of three interventional modalities for the prevention and treatment of obesity – dietary counseling, pharmaceutical interventions and bariatric surgery – were calculated by building a model using primary Israeli data for dietary counseling interventions, as well as by adapting data from the published literature to epidemiological and economic parameters characterizing Israel for all three interventional modalities. Public health interventions such as those delivered at schools, worksites and other community settings were not covered as the literature does not provide sufficient information to calculate generalizable cost-utility analyses. Generally, the ratios were found to be very favorable: the majority were either cost-saving or very cost-effective. Cost-saving interventions are those that actually reduce costs overall, as the treatment costs averted by the decrease in morbidity exceed the cost of the intervention. Very cost-effective interventions are those that achieve an increase in quality-adjusted life years (QALYs) at a relatively low cost (the cost per QALY is less than the per capita GNP, in keeping with the accepted WHO criteria). Dietary counseling was either cost-saving or very cost-effective, while pharmaceutical interventions were either very cost-effective or cost-effective. The various surgical interventions ranged from being cost-saving to cost-effective, contingent upon the specific technique and the study. Generally speaking, these three modalities incrementally address populations that are increasingly more obese or difficult to treat. As such, they essentially do not compete with one another. Differences in cost-effectiveness exist within each treatment modality, but the data are not robust enough to facilitate within-modality prioritization at this point. This report confirms the cost-effectiveness of several interventions already funded to some degree within the basket of health services but also suggests the appropriateness of funding heretofore unfunded interventions. While funding exists for dietary counseling for the obese or the severely overweight with additional risk factors and for surgical interventions for those with Class III obesity or with Class II obesity and additional risk factors, pharmaceutical interventions such as sibutramine and orlistat are …