Advanced

Bariatric Surgery can Lead to Net Cost Savings to Health Care Systems: Results from a Comprehensive European Decision Analytic Model

Borisenko, Oleg; Adam, Daniel; Funch-Jensen, Peter; Ahmed, Ahmed R.; Zhang, Rongrong; Colpan, Zeynep and Hedenbro, Jan LU (2015) In Obesity Surgery 25(9). p.1559-1568
Abstract
The objective of the present study was to evaluate the cost-utility of bariatric surgery in a lifetime horizon from a Swedish health care payer perspective. A decision analytic model using the Markov process was developed covering cardiovascular diseases, type 2 diabetes, and surgical complications. Clinical effectiveness and safety were based on the literature and data from the Scandinavian Obesity Surgery Registry. Gastric bypass, sleeve gastrectomy, and gastric banding were included in the analysis. Cost data were obtained from Swedish sources. Bariatric surgery was cost saving in comparison with conservative management. It also led to a substantial reduction in lifetime risk of events: from a 16 % reduction in the risk of transient... (More)
The objective of the present study was to evaluate the cost-utility of bariatric surgery in a lifetime horizon from a Swedish health care payer perspective. A decision analytic model using the Markov process was developed covering cardiovascular diseases, type 2 diabetes, and surgical complications. Clinical effectiveness and safety were based on the literature and data from the Scandinavian Obesity Surgery Registry. Gastric bypass, sleeve gastrectomy, and gastric banding were included in the analysis. Cost data were obtained from Swedish sources. Bariatric surgery was cost saving in comparison with conservative management. It also led to a substantial reduction in lifetime risk of events: from a 16 % reduction in the risk of transient ischaemic attacks to a 62 % reduction in the incidence of type 2 diabetes. Over a lifetime, surgery led to savings of a,not sign8408 and generated an additional 0.8 years of life and 4.1 quality-adjusted life years (QALYs) per patient, which translates into gains of 32,390 quality-adjusted person-years and savings of a,not sign66 million for the cohort, operated in 2012. Analysis of the consequences of a 3-year delay in surgery provision showed that the overall lifetime cost of treatment may be increased in patients with diabetes or a body mass index > 40 kg/m(2). Delays in surgery may also lead to a loss of clinical benefits: up to 0.6 life years and 1.2 QALYs per patient over a lifetime. Bariatric surgery, over a lifetime horizon, may lead to significant cost savings to health care systems in addition to the known clinical benefits. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bariatric surgery, Cost-utility analysis, Cost-effectiveness analysis, Health economics, Cost, Sweden
in
Obesity Surgery
volume
25
issue
9
pages
1559 - 1568
publisher
Springer
external identifiers
  • wos:000358782100001
  • scopus:84938423459
ISSN
1708-0428
DOI
10.1007/s11695-014-1567-5
language
English
LU publication?
yes
id
72bc87cf-4a57-49d1-82fe-216ba41f6b88 (old id 7975848)
date added to LUP
2015-10-01 07:34:49
date last changed
2017-10-01 04:13:18
@article{72bc87cf-4a57-49d1-82fe-216ba41f6b88,
  abstract     = {The objective of the present study was to evaluate the cost-utility of bariatric surgery in a lifetime horizon from a Swedish health care payer perspective. A decision analytic model using the Markov process was developed covering cardiovascular diseases, type 2 diabetes, and surgical complications. Clinical effectiveness and safety were based on the literature and data from the Scandinavian Obesity Surgery Registry. Gastric bypass, sleeve gastrectomy, and gastric banding were included in the analysis. Cost data were obtained from Swedish sources. Bariatric surgery was cost saving in comparison with conservative management. It also led to a substantial reduction in lifetime risk of events: from a 16 % reduction in the risk of transient ischaemic attacks to a 62 % reduction in the incidence of type 2 diabetes. Over a lifetime, surgery led to savings of a,not sign8408 and generated an additional 0.8 years of life and 4.1 quality-adjusted life years (QALYs) per patient, which translates into gains of 32,390 quality-adjusted person-years and savings of a,not sign66 million for the cohort, operated in 2012. Analysis of the consequences of a 3-year delay in surgery provision showed that the overall lifetime cost of treatment may be increased in patients with diabetes or a body mass index > 40 kg/m(2). Delays in surgery may also lead to a loss of clinical benefits: up to 0.6 life years and 1.2 QALYs per patient over a lifetime. Bariatric surgery, over a lifetime horizon, may lead to significant cost savings to health care systems in addition to the known clinical benefits.},
  author       = {Borisenko, Oleg and Adam, Daniel and Funch-Jensen, Peter and Ahmed, Ahmed R. and Zhang, Rongrong and Colpan, Zeynep and Hedenbro, Jan},
  issn         = {1708-0428},
  keyword      = {Bariatric surgery,Cost-utility analysis,Cost-effectiveness analysis,Health economics,Cost,Sweden},
  language     = {eng},
  number       = {9},
  pages        = {1559--1568},
  publisher    = {Springer},
  series       = {Obesity Surgery},
  title        = {Bariatric Surgery can Lead to Net Cost Savings to Health Care Systems: Results from a Comprehensive European Decision Analytic Model},
  url          = {http://dx.doi.org/10.1007/s11695-014-1567-5},
  volume       = {25},
  year         = {2015},
}