Interventions:
The comparators were appropriately selected as the proposed programme was compared against the standard care, which was no intervention. An extensive description of the weight management programme was given.
Effectiveness/benefits:
The clinical evidence came from one group of patients, who acted as their own controls, with baseline data used to represent the outcomes in the absence of the intervention. Participation was voluntary, which means that these employees might not have been representative of all individuals eligible for the intervention. There were key differences between the dropouts and the intervention completers. No formal justification for the size of the sample was provided. These issues might affect the validity of the clinical analysis.
Costs:
The economic analysis was restricted to the drug costs. The inclusion of other medical services would have been interesting. The cost of the programme was not calculated, but the authors stated that it could have been as high as $6,000 and still have been cost saving; it was not clear how this figure was estimated. Limited information on the unit costs and resource quantities was provided. The authors stated that the cost savings were calculated in a speculative manner, because the actual prices of drugs used by the participants were not available. The cost estimates were treated deterministically.
Analysis and results:
The results were clearly reported, but the economic and the clinical outcomes were not synthesised and a cost-consequences analysis was conducted. The issue of uncertainty was not investigated. The authors acknowledged some limitations of their analysis, such as the non-randomised study design, the risk of selection bias, the exclusion of some cost categories, and the small sample for the long-term analysis.
Concluding remarks:
The study had several methodological limitations that might affect the validity of the authors’ conclusions. Further studies are needed to corroborate these findings.
