Disease-specific reference case extension: management of overweight and obesity in adults

If there is clear evidence of a significant burden of health inequalities, a distributional cost-effectiveness analysis (DCEA) could be undertaken with results presented, as supporting evidence, by deprivation quintile groups. If a DCEA is undertaken, this should be by stratum and variation in take-up and adherence to treatment across deprivation group should be captured as well as variation in prevalence of disease. This analysis could be particularly helpful to encourage uptake of interventions that may support tackling health inequalities. (recommended)  

Do not include cost-effectiveness results by these deprivation quintile groups as part of the base-case analysis or present them as non-reference case scenarios. (required)

Some benefits and risks might be difficult to fully capture quantitatively in the modelling. Therefore, consider qualitatively the impact of the intervention on the following:

• health inequalities related to protected characteristics, for example, South Asian ethnicity or disability such as severe mental illness, autism or learning disability, because incidence of obesity is higher in these groups (recommended)

• access to other treatments, for example, organ transplants (recommended)

• treatment-related outcomes, for example, fertility (recommended)

• the health of unborn children (recommended)

• in the case of bariatric procedures, how recovery time impacts carers, workers and those from deprived areas more than others. (recommended)