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. 2021 Apr;29(4):654-661.
doi: 10.1002/oby.23117.

Return on Investment: Medical Savings of an Employer-Sponsored Digital Intensive Lifestyle Intervention, Weight Loss

Cecelia M Horstman  1 , Donna H Ryan  2 , Louis J Aronne  3 , Caroline M Apovian  4 , John P Foreyt  5 , Hannah M Tuttle  1 , Donald A Williamson  2
Affiliations

Return on Investment: Medical Savings of an Employer-Sponsored Digital Intensive Lifestyle Intervention, Weight Loss

Cecelia M Horstman et al. Obesity (Silver Spring). 2021 Apr.

Abstract

Objective: This study aimed to determine the medical cost impact and return on investment (ROI) of a large, commercial, digital, weight-management intensive lifestyle intervention (ILI) program (Real Appeal).

Methods: Participants in this program were compared with a control group matched by age, sex, geographic region, health risk, baseline medical costs, and chronic conditions. Medical costs were defined as the total amount paid for all medical expenses, inclusive of both the insurers' and the study participants' responsibility.

Results: In the 3 years following program registration, the intent-to-treat (ITT) cohort had significantly lower medical expenditures than the matched controls, with an average of -$771 or 12% lower costs (P = 0.002). Among 4,790 ITT participants, a total savings of $3,693,090 compared with total program costs of $1,639,961 translated into a 2.3:1 ROI. Program completers (n = 3,990), who attended more sessions than the overall ITT group, had greater mean weight loss (-4.4%), greater cost savings (-$956 or 14%), and an ROI of 2.0:1 over the 3-year time frame compared with matched controls.

Conclusions: The findings demonstrated that the digital weight-management ILI was associated with a significantly positive ROI. Employers and payers willing to cover the cost of an ILI that produces both weight loss and demonstrated cost benefits can improve health and save money for their population with overweight or obesity.

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Conflict of interest statement

CMH is the Director of Health Outcomes and HT is a product manager at Rally Health, which administers the Real Appeal program. LJA, CMA, JPF, DHR, and DAW received financial remuneration for service on the Scientific Advisory Board of Real Appeal. DHR has received financial remuneration for advisory services to Novo Nordisk, Orexigen, Eisai, Sanofi, Scientific Intake, Gila Therapeutics, and Merck. DHR has served as a speaker for Novo Nordisk, Orexigen, and Eisai and has an equity interest in Scientific Intake and Gila Therapeutics. HMT is employed by Rally Health, which manages the program. DHR serves on a Data Safety Monitoring Board for Baro Nova. LA serves on the Board of Directors for Myos Corporation and Jamieson Wellness. LJA has received remuneration for advisory services to Sanofi, Janssen, and UnitedHealth Group. LJA has received financial remuneration as a consultant, speaker, and advisor or has received research support from Aspire Bariatrics, Inc., Eisai, Inc., Novo Nordisk, Pfizer, Takeda Pharmaceuticals, and Zafgen, Inc. LJA has an equity interest in Zafgen, Inc., BMIQ/Intellihealth, Myos, Gelesis, and ERX, and he has received research support from Astra Zeneca. CMA has received grants and personal fees from Gelesis and Novo Nordisk, personal fees from Orexiegn, Allergan, Abbott Nutrition, EnteroMedics, Zafgen, Nutrisystem, Scientific Intake, Bariatrix Nutrition, SetPoint Health, Xeno Biosciences, Rhythm, Janssen, Tivity Health, Roman Health Ventures, and Jazz. DAW serves on the Clinical Advisory Board for the CALIBRATE weight‐management program.

Figures

Figure 1
Figure 1
Average differences in health care costs ($) between baseline and 3 years after registration for program participants and matched controls for the intent‐to‐treat cohort.
Figure 2
Figure 2
Medical cost savings: the difference‐in‐differences in health care cost ($) over 3 years between program participants and their matched controls.
See this image and copyright information in PMC

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