Cost-effectiveness of Bariatric Surgery: Increasing the Economic Viability of the Most Effective Treatment for Type II Diabetes Mellitus

Abstract

There has been considerable debate on the cost-effectiveness of bariatric surgery within larger population groups. Despite the recognition that morbid obesity and its comorbidities are best treated surgically, insurance coverage is not universally available. One of the more costly comorbidities of obesity is Type II diabetes mellitus (T2DM). We propose a model that demonstrates the cost-effectiveness of increasing the number of bariatric surgical operations performed on patients with T2DM in the United States. We applied published population cost estimates (2012) for medical care of T2DM to a retrospective cohort of morbidly obese patients in South Carolina. We compared differences in 10-year medical costs between those having bariatric surgery and controls. Resolution of T2DM in the bariatric cohort was assumed to be 40 per cent. Considering only the direct medical costs of T2DM, the 10-year aggregate cost savings compared with a control group is $2.7 million/1000 patients; the total (direct and indirect) cost savings is $5.4 million/1000 patients. When considering resolution of T2DM alone, increasing the number of bariatric operations for a given population leads to a substantial cost savings over a 10-year period. This study adds to the growing body of evidence suggesting that bariatric surgery is a cost-effective means of caring for the obese patient.

Diverse approaches to the health economic evaluation of bariatric surgery: a comprehensive systematic review

“…Fifty six percent ( n = 43) of studies' data is predominantly is sourced from or originated from the USA . Studies also originated from Sweden 10% ( n = 8), Australia 8% ( n = 6), UK 8% ( n = 6), Canada , and the remainder of the included studies each for France ( n = 2),Germany , (Austria, Italy, Spain) , Spain , Norway , Portugal , the Netherlands , Finland , South Korea , Brazil ( n = 2) and Mexico .…”

“…Of those that reported a time horizon, 42% ( n = 32) adopted a timeframe of ≤5 years and 53% of these studies reported results for ≤2 years ( n = 17) (mostly cost and cost analyses). Some cost and cost analyses reported a longer time horizon of 6–10 years ( n = 12, 16%) or 11–20 years ( n = 3, 4%) . In these studies, there was a significant loss of participants to follow‐up in the later years for large samples or analyses were informed by a small sample from a single study centre .…”

Through Thick and Thin: Identifying Barriers to Bariatric Surgery, Weight Loss Maintenance, and Tailoring Obesity Treatment for the Future

“…If we take into account only the cost of treating type 2 diabetes mellitus in the obese population, we could expect direct 10-year aggregate cost savings of $2.7 million/1000 people. The indirect cost, which takes into account the cost paid by society in terms of loss of work productivity due to sick leave or disability, has been proposed at $5.4 million/1000 [ 24 ]. Moreover, others have estimated the indirect cost of obesity to cost our society $48 billion to $64 billion annually [ 25 , 26 ].…”

Limitations of the DiaRem Score in Predicting Remission of Diabetes Following Roux-En-Y Gastric Bypass (RYGB) in an ethnically Diverse Population from a Single Institution in the UK

“…Roux-en-Y gastric bypass (RYGB) surgery is currently the most effective treatment for T2DM resulting in long-term remission in a proportion of patients [ 2 – 4 ]. Whilst considered cost-effective and safe, the availability of the operation is unable to meet the demand due to the rapidly rising prevalence of obesity [ 5 , 6 ]. Furthermore, although RYGB may result in improvement in obesity comorbidities, not all patients with diabetes undergo remission.…”