2 ________________________________________________ _ Current Issues in Pharmacoeconomics US guidelines spur the development of obesity programmes The widespread circulation of the US National Heart, Lung, and Blood Institute guidelines for weight reduction may increase the number and success of weight-loss management programmes, reports Disease Management News. Of the small number of weight-loss programmes that have been introduced, few have been successful due to poor reimbursement by managed-care organisations (MCOs), as well as prejudice against patients with obesity, says US consultant Or Walter Elias. Furthermore, disease management (OM) vendors do not view obesity as a stand-alone market as they do not have a clinical solution for improving outcomes. Therefore, widespread implementation of the new weight reduction guidelines could provide that solution, notes Dr Shiriki Kumanyika from the University of Illinois in Chicago.

Obesity worth paying for? Or Kumanyika believes that the guidelines will help change patients' and physicians' perceptions of the impact of obesity on overall health status. This in turn could lead to a change in reimbursement policies if MCOs decide that obesity programmes are worth paying for. Subsequently, there could be an increase in obesity OM initiatives, particularly in combination with programmes for other related conditions such as diabetes mellitus, hypertension and coronary artery disease. For example, Kaiser Permanente in Oakland, California, has introduced a behavioural-based obesity OM programme that has been incorporated into programmes for a variety of other costly chronic conditions. Kaiser is currently determining what outcomes to measure, and does not view the programme as a 'money making' exercise, says Or Susan Kayman from Kaiser. Weight-loss DM could get boost from new government guidelines. Disease Il0072227. Management News 4: I & 5. \0 Nov 1998

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