Endoscopic sleeve gastroplasty vs lifestyle modification for weight loss: A real-world cost-effectiveness study

Figure 1 Model schematic. Patients enter the model in one of five body mass index (BMI)-group health states: Healthy weight, overweight, and class I-III obesity. Patients in the overweight to class III obesity health states receive either endoscopic sleeve gastroplasty + lifestyle modification or lifestyle modification alone. Patients cycle between health states (e.g., from overweight to class I, or from class III to class II) based on transition probabilities from real-world data, established BMI-group associated mortality risks and key opinion leader opinion, as included in the model. Patients could also move from any of the 5 BMI group-based health states to an absorbing (i.e., irreversible) mortality death state and would not be able to re-enter another state during a future cycle. Cycle length is set at twice yearly for the first year, and then yearly through 5 years in the base-case. Patients can move states each cycle. BMI: Body mass index.