Seamus Kent: the DROPLET study

Posted On: 15th July 2019

“Studies like ours, which provide reliable estimates of the long-term impacts of weight management programmes on patients’ health and healthcare costs, are of real importance to enable the NHS to select the most clinically and cost-effective services for their patients.”[1]

Seamus Kent, health economist at the University of Oxford, presents his findings concerning the cost effectiveness of total diet replacement programmes (TDRs) in the DROPLET study, in which patients are referred to a TDR by their doctor, compared with nurse-led behavioural support.

The results

Compared with regular weight loss support from a practice nurse, a programme of weekly behavioural support and TDR seems to be tolerable and leads to substantially greater weight loss. At current retail prices and with plausible long‐term weight regain trajectories, TDR is projected to be cost‐effective in adults with obesity and should be considered as an option to treat obesity in routine health care settings.

he study estimated that, for every 100,000 people referred to the TDR programme, 50 coronary heart disease events, 75 strokes, 900 cases of type 2 diabetes, and 25 cancers could be avoided. As a result, people are expected to live longer and in better health, with lower use and costs of healthcare services. The TDR programme is expected to cost an additional £13,000 for every year of life lived in full health which is gained as a result of the treatment. In the UK, healthcare interventions are generally considered cost-effective if they provide such a benefit for less than £20,000.

Reactions to the study

Following these results, Professor Susan Jebb, Professor of Diet and Population Health in University of Oxford’s Nuffield Department of Primary Care Health Sciences, Chief investigator of the DROPLET trial, said: “It is great to see the NHS Long Term Plan taking this research evidence and translating it into new clinical services for people who are obese. Our study provides great confidence that this programme is a cost-effective treatment, which could improve the health of large numbers of people who are affected by obesity.”

Professor Anthony Leeds, chairman of TDMR Europe, said of the results of the study: “We very much welcome the results of this study. Health care costs are higher among older and heavier people, so it is not a surprise to find that GP referral to a Total Diet Replacement (TDR) programme delivered in the community is most cost effective among those over 50 years and those with a BMI over 35. This fits with the typical age and weight of people with Type 2 diabetes, osteoarthritis and other obesity-related co-morbidities.”

[1] Kent, 2019,