title: Medication costs during an 18 month clinical trial of obesity treatment among patients encountered in primary care.
abstract: BACKGROUND
  Weight loss often leads to reductions in medication costs, particularly for weight-related conditions. We aimed to evaluate changes in medication costs from an 18 month study of weight loss among patients recruited from primary care.
  
  
  METHODS
  Study participants (n = 79, average age = 56.3; 75.7 % female) with average BMI of 39.5 kg/m(2), plus one co-morbid condition of either diabetes/pre-diabetes, hypertension, abnormal cholesterol, or sleep apnea, were recruited from 2 internal medicine practices. All participants received intensive behavioral and dietary treatment during months 0-6, including subsidized access to portion-controlled foods for weight loss. From months 7-18, all participants were offered continued access to subsidized foods, and half of participants were randomly assigned to continue in-person visits ("Intensified Maintenance"), while the other half received materials by mail or e-mail ("Standard Maintenance"). Medication costs were evaluated at months 0, 6, and 18.
  
  
  RESULTS
  Participants assigned to Intensified Maintenance maintained nearly all their lost weight, whereas those assigned to Standard Maintenance regained weight. However, no significant differences in medication costs were observed within or between groups during the 18 months of the trial. A reduction of nearly $30 per month (12.9 %) was observed among all participants from month 0 to month 6 (active weight loss phase), but this difference did not reach statistical significance.
  
  
  CONCLUSIONS
  A behavioral intervention that led to clinically significant weight loss did not lead to statistically significant reductions in medication costs. Substantial variability in medication costs and lack of a systematic approach by the study team to reduce medications may explain the lack of effect.
  
  
  BACKGROUND
  The trial was registered at (NCT01220089) on September 23, 2010.
authors.affiliation: Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, USA ; Anschutz Health and Wellness Center, University of Colorado School of Medicine, Aurora, USA ; Kaiser Permanente of Colorado, Departments of Internal Medicine and Metabolic-Surgical Weight Management, 2045 Franklin Street, 3rd Floor, Denver, USA.
authors.forename: Adam G
authors.initials: AG
authors.lastname: Tsai
authors.affiliation: Department of Biostatistics, Colorado School of Public Health, Aurora, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Juarez-Colunga
authors.affiliation: Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, USA ; Anschutz Health and Wellness Center, University of Colorado School of Medicine, Aurora, USA.
authors.forename: Sue
authors.initials: S
authors.lastname: Felton
authors.affiliation: Department of Medicine, Denver Health Medical Center, Denver, USA.
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: Speer
authors.affiliation: Anschutz Health and Wellness Center, University of Colorado School of Medicine, Aurora, USA ; Department of Medicine, Denver Health Medical Center, Denver, USA.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Bessesen
authors.affiliation: Department of Health Systems, Management, and Policy, Colorado School of Public Health, Aurora, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Atherly
keywords: Clinical trial; Health care utilization; Medications; Obesity