--- title: "Cost-effectiveness of weight-loss interventions for knee osteoarthritis: systematic review" id: "bmj-open-7-systematic-review-of-cost-effectiveness-analyses-of-weight-loss-interventions" canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-7-systematic-review-of-cost-effectiveness-analyses-of-weight-loss-interventions" content_type: "clinical_feed_article" specialty: "Rheumatology" source_name: "BMJ Open" source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e117500?rss=1" published_at: "2026-09-22T17:11:09.000Z" evidence_level: "Journal Feed" license: "CC-BY-NC-4.0 / Informational Use" --- # Cost-effectiveness of weight-loss interventions for knee osteoarthritis: systematic review ## Provenance & Clinical Metadata - **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-7-systematic-review-of-cost-effectiveness-analyses-of-weight-loss-interventions - **Specialty:** [Rheumatology](https://medichelpline.com/clinical-feed/rheumatology.md) - **Primary Source:** BMJ Open - **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e117500?rss=1) - **Published At:** 2026-09-22T17:11:09.000Z - **Evidence Rating:** Journal Feed ## Executive GIST (TL;DR) - This systematic review evaluated the **cost-effectiveness** of intentional **weight-loss interventions** in adults (≥18 years) with **knee osteoarthritis (OA)** and obesity, using studies published up to June 2025. - Databases searched included MEDLINE, EMBASE via Ovid, Global Index Medicus, Web of Science and ClinicalTrials.gov; English-language studies with economic outcomes were eligible. - From 1,014 references screened, eight studies met inclusion criteria: six model-based economic evaluations and two randomized trials. - Most studies applied lifetime horizons and reported results from healthcare and/or societal perspectives. - Combined diet-and-exercise programmes produced QALY gains of 0.05–0.16 with incremental cost-effectiveness ratios (**ICERs**) of £16,915 and £31,305 per **QALY**. - **Bariatric surgery** produced larger QALY gains (0.81–1.7) at lower ICERs (£4,361 to £19,303 per QALY), making it the intervention most likely to be cost-effective within UK thresholds. - Pharmacological interventions yielded effectiveness but were relatively costly, with reported ICERs of £32,265 to £35,832 per QALY; their value depends on drug pricing and willingness-to-pay thresholds. - Telehealth-only interventions showed mixed economic results, with ICERs reported from non-significant effects to £32,722 per QALY gained. - Included studies met 79–86% of items on the CHEERS checklist and were rated good on the Drummond checklist. - Authors conclude bariatric surgery appears most likely to be cost-effective using UK thresholds (£25,000–£35,000/QALY), but evidence is mainly from US model-based studies; high-quality UK economic evaluations are needed, especially for **GLP-1** receptor agonists. ## Clinical Analysis & Structured Key Points Objectives We evaluated the cost-effectiveness of weight-loss interventions for adults with knee osteoarthritis (OA) and obesity. Design Systematic review and narrative synthesis. Data sources MEDLINE, EMBASE via Ovid, Global Index Medicus and Web of Science and a clinical trial registry (ClinicalTrials.gov), published up to June 2025. Eligibility criteria English-language studies evaluating the cost-effectiveness of intentional weight-loss interventions in adults (≥18 years) with knee OA were included. Studies without cost-effectiveness outcomes, abstracts and conference proceedings were excluded. Data extraction and synthesis Two reviewers independently extracted study characteristics and economic outcomes. A narrative synthesis was conducted and costs were standardised to 2024 British pounds. Results 1014 references were identified; eight studies met inclusion criteria, including six model-based economic evaluations and two randomised trials. Most studies used lifetime horizons and presented data from healthcare or societal perspectives. Combined diet and exercise programmes showed quality-adjusted life years (QALY) gains of 0.05 - 0.16 with incremental cost-effectiveness ratios (ICERs) of £16 915 and £31 305 per QALY, while bariatric surgery yielded larger gains (0.81 - 1.7 QALYs) at lower ICERs (£4361 to £19 303 per QALY). Pharmacological interventions were effective but costly with ICER (£32 265 to £35 832 per QALY). Evidence regarding telehealth-only interventions was mixed, with reported ICERs ranging from no significant effect to £32 722 per QALY gained. The included studies fulfilled 79 - 86% of the criteria from Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and were all rated good on the Drummond checklist. Conclusions Using standard UK cost-effectiveness thresholds (£25 000 to £35 000 per QALY), bariatric surgery appears most likely to be cost-effective for patients with knee OA, although this conclusion is based primarily on US model-based evidence. Pharmacological therapies may be cost-effective, although their economic value is sensitive to drug pricing and willingness-to-pay thresholds. High-quality UK-based economic evaluations are needed to establish the cost-effectiveness of Glucagon-Like Peptide-1 (GLP-1) receptor agonists for knee OA. ## Related Clinical Research - [Trump administration drug-pricing plan: Did Novo Nordisk get an extra financial win?](https://medichelpline.com/clinical-feed/stat-news-0-stat-did-the-trump-administration-just-cut-novo-a-huge-financial-win.md) - [Novo and Medicare’s Bridge program: what STAT reported and what wasn’t disclosed](https://medichelpline.com/clinical-feed/stat-news-1-stat-novo-may-be-getting-a-better-deal-than-expected-with-medicare-s-bridge.md) - [AHA and AHS fund research on the heart–brain link in migraines and stroke risk](https://medichelpline.com/clinical-feed/aha-news-2-new-scientific-research-projects-study-heart-brain-connection-to-migraines.md) - [Dopamine-Secreting Paraganglioma Suppressed a Prolactinoma: A Case Report](https://medichelpline.com/clinical-feed/endocrine-news-0-double-trouble-functional-suppression-of-a-prolactinoma-by-a-dopamine-secreting.md) - [Mathematical model reveals how stress and circadian disruption drive adipogenic commitment via PPA](https://medichelpline.com/clinical-feed/biorxiv-22-deciphering-the-dynamical-origin-of-the-adipogenic-commitment-during-stress.md) ## Navigation - [← Back to Rheumatology Feed](https://medichelpline.com/clinical-feed/rheumatology.md) - [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md) ## Medical & Regulatory Disclaimer > [!CAUTION] > MedicHelpline content is structured for research, educational, and professional discovery purposes. 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