2026/04/09 by Fang Chen, Timothy M. Dall, Catherine Ferguson +6 · 1 voice · 2 citations
Medicine · #Bariatric Surgery and Outcomes #Diabetes Treatment and Management #Pharmacology and Obesity Treatment
paper · doi:10.2337/doci25-0004
openalex publication_date 2026/04/09 · openalex created_date 2026/04/10 · openalex updated_date 2026/07/31
OBJECTIVE To describe the Disease Prevention and Treatment Microsimulation Model (DPTMM) for projecting long-term clinical and economic outcomes of obesity interventions across diverse U.S. populations. RESEARCH DESIGN AND METHODS The DPTMM uses a Markov microsimulation framework projecting health and economic trajectories through annual cycles. The model covers nearly 40 clinical outcomes and comprehensive economic impacts, including medical costs, productivity, quality-adjusted life-years, and mortality benefits. The synthetic population uses nationally representative data, with model inputs from published clinical trials, observational studies, and national data sources. The framework addresses how treatment effects vary across populations with different baseline characteristics, complex time-dependent weight loss relationships, and multiple interconnected pathways of obesity’s health effects. Model outputs were compared with published studies. RESULTS The analysis focused on 97.7 million insured adults with obesity in 2025 (57.6 million commercially insured individuals, 25.2 million Medicare beneficiaries, and 14.9 million Medicaid enrollees). Ten-year per-person benefits varied substantially by intervention type, baseline health status, and insurance population. Among commercially insured adults with complications receiving modern obesity medications (GLP-1 and GIP/GLP-1 receptor agonists), cumulative benefits totaled 326,021, including 32,600 in medical savings, 101,238 in productivity improvements, 50,935 in health-related quality-of-life improvements among survivors, and 141,247 in mortality reduction value. Modern obesity medications achieved 50–52% diabetes risk reduction among commercially insured and Medicaid-enrolled adults vs. 19% among Medicare beneficiaries. Health-related quality of life and mortality reductions comprised 50–70% of total benefits. CONCLUSIONS Obesity treatment value extends substantially beyond medical cost savings to encompass workplace productivity, health-related quality of life, and mortality improvements.