Charles Baum, M.D., M.S., FACG, FTOS Vice President and Head U.S. Medical Affairs Vice President and Head U.S. Medical Affairs Takeda Pharmaceuticals International 1
Recognizing Obesity as a Disease • Obesity recognized as a disease - American Medical Association (June 2013) Ob Obesity Guidelines/Position Statements it G id li /P iti St t t AACE Surgery Surgery ENDO/TOS ACP VA/D D VA/DoD AGA Pharmacotherapy Pharmacotherapy Lifestyle Modification Lifestyle Modification Lifestyle Modification Lifestyle Modification Diet Diet Physical Activity Physical Activity 2
Multifaceted Medical Weight Loss Approaches Are Most Effective Approaches Are Most Effective • In a randomized clinical trial of obese patients, those subjects who received combination therapy lost more weight than subjects undergoing a structured lifestyle intervention or pharmacotherapy alone 1 i i h h l 1 Pharmacotherapy alone (n=45) Structured Lifestyle Intervention alone (n=47) 0 Combined Therapy (pharmacotherapy + Structured lifestyle Intervention) (n=49) 2 4 4 g Weight Loss, kg 6 8 10 W 12 14 16 0 3 6 10 52 18 40 Weeks • Another randomized controlled prospective study found significantly greater mean weight loss with pharmacotherapy plus lifestyle intervention after 1 year and 4 years compared with lifestyle intervention alone (p<0 001) 2 compared with lifestyle intervention alone (p<0.001) 2 1. Wadden et al, N Engl J Med 2005; 353:2111-20 (adapted with permission) 3 2. Torgerson et al, Diabetes Care 2004;27:155-61
New Approaches to Obesity Pharmacotherapy : Designed to maximize weight loss, maintenance, g g , , program adherence, access & affordability • Safe and effective for both weight loss induction and weight maintenance including novel dosing Product regimens • Evidence for improvement in clinical outcomes and overall cost • Evidence-based lifestyle/BMOD program results in y p g Program additive effects on weight loss and adherence • Program is integrated into benefits design • Sustainable • Voucher programs insure affordable pricing Affordable • Reliable price with progressive savings at retail pharmacy (behavioral economics) Access • Novel payer partnerships such as risk-based contracting are needed to enhance coverage
Digital technology expands reach and allows for personalized tailoring: The ScaleDown approach • Results − Higher engagement, lower recidivism with lower intensity − Comparable weight loss as seen with f face to face lifestyle management t f lif t l t programs DPP Look Ahead ScaleDown Weight loss 7% 5% 7% > 5% weight loss at 50% 43% 43% 6 months Face to face 16 28 1 sessions 5
Comprehensive Community Approaches to Obesity Individuals, Families, Communities, Society Schools Businesses Faith-Based Initiatives ics l Economi Mess Med Physical Physical dia Behaviora Healthy ages Activity Food Opport. Environment B Healthcare Systems Obesity Treatment 6 Baum C. Pharmacoeconomics. 2015 Feb 17. [Epub]
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