Psy23 Cost-Effectiveness of Laparoscopic Adjustable Gastric Banding and Laparoscopic Roux-en-Y Gastric Bypass in the Treatment of Morbid Obesity

Campbell, Joanna; McGarry, LJ; Thompson, Dola S.; Gilmore, Katherine Ramsey; Hill, Graham L.; Lee, J; Hale, B.C.; Shikora, Scot; Weinstein, MC

doi:10.1016/s1098-3015(10)70504-0

Cited by 6 publications

(24 citation statements)

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“…Examples of these inputs and their relationship to each perspective (i.e., payer, employer, and society) are listed in Figure 3. The direct impact of the LAGB procedure (including expenses pre-and post-procedure) was calculated based on two different sources: (1) a cost-effectiveness model and (2) a paired sample study by Crémieux et al 4,24,25 . The methodologies of these sources are described within their studies.…”

Section: Methodsmentioning

confidence: 99%

Obesity-related costs and the economic impact of laparoscopic adjustable gastric banding procedures: benefits in the Texas Employees Retirement System

Perryman¹,

Gleghorn²

2010

Journal of Medical Economics

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Section: Methodsmentioning

confidence: 99%

Obesity-related costs and the economic impact of laparoscopic adjustable gastric banding procedures: benefits in the Texas Employees Retirement System

Perryman¹,

Gleghorn²

2010

Journal of Medical Economics

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“…Every month of the simulation, patients could transition among health states defined by BMI status (normal, 18-24.9; overweight, 25-29.9; mild obesity, 30-34.9; moderate obesity, 35-39.9; and severe obesity, Ն40), T2D status (baseline severity, remission, and relapse to baseline severity), surgery complications, and mortality (Figure 1). Model inputs were derived from clinical trials, large cohort studies, national databases, and published literature 4,6,7,11,[15][16][17][18][19][20][21][22][23][24][25] (Table 1).…”

Section: Model Overviewmentioning

confidence: 99%

“…7 We assumed the risk of late complication was constant for the first 4 years, reduced by 50% in years 5 to 10, and 0 after 10 years. 18 Patients were also at risk of surgery-related mortality within the first month. 19 Afterward, all-cause mortality rates were estimated using BMI-specific life tables.…”

Section: Complications and Mortalitymentioning

confidence: 99%

Estimated Cost-effectiveness of Medical Therapy, Sleeve Gastrectomy, and Gastric Bypass in Patients With Severe Obesity and Type 2 Diabetes

et al. 2022

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IMPORTANCE Bariatric surgery is recommended for patients with severe obesity (body mass index Ն40) and type 2 diabetes (T2D). However, the most cost-effective treatment remains unclear and may depend on the patient's T2D severity. OBJECTIVETo estimate the cost-effectiveness of medical therapy, sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) among patients with severe obesity and T2D, stratified by T2D severity. DESIGN, SETTING, AND PARTICIPANTS This economic evaluation used a microsimulation model to project health and cost outcomes of medical therapy, SG, and RYGB over 5 years. Time horizons varied between 10 and 30 years in sensitivity analyses. Model inputs were derived from clinical trials, large cohort studies, national databases, and published literature. Probabilistic sampling of model inputs accounted for parameter uncertainty. Estimates of US adults with severe obesity and T2D were derived from the National Health and Nutrition Examination Survey. Data analysis was performed from January 2020 to August 2021. EXPOSURES Medical therapy, SG, and RYGB. MAIN OUTCOMES AND MEASURESQuality-adjusted life-years (QALYs), costs (in 2020 US dollars), and incremental cost-effectiveness ratios (ICERs) were projected, with future cost and QALYs discounted 3.0% annually. A strategy was deemed cost-effective if the ICER was less than $100 000 per QALY. The preferred strategy resulted in the greatest number of QALYs gained while being costeffective. RESULTSThe model simulated 1000 cohorts of 10 000 patients, of whom 16% had mild T2D, 56% had moderate T2D, and 28% had severe T2D at baseline. The mean age of simulated patients was 54.6 years (95% CI, 54.2-55.0 years), 61.6% (95% CI, 60.1%-63.4%) were female, and 65.1% (95% CI, 63.6%-66.7%) were non-Hispanic White.

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“…Costs associated with treatment strategies, surgical complications, and health states were derived from the literature. [27][28][29][30][31][32] The initial cost of GB was based on a prior analysis, 27 and the cost of SG was calculated using cost data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. 28 All costs from prior years were converted to 2017 $US using the Consumer Price Index.…”

Section: Costs and Quality-of-life Adjustmentsmentioning

confidence: 99%

“…Complications also incurred additional costs. 27 We adjusted quality of life based on patients' age, sex, and weight class (eTable 2 in the Supplement).…”

Section: Costs and Quality-of-life Adjustmentsmentioning

confidence: 99%

Cost-effectiveness Analysis of Bariatric Surgery for Patients With Nonalcoholic Steatohepatitis Cirrhosis

et al. 2019

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Key Points Question Is bariatric surgery cost-effective in patients with nonalcoholic steatohepatitis and compensated cirrhosis? Findings In this simulation model study, laparoscopic sleeve gastrectomy had an incremental cost-effectiveness ratio of $66 119 per quality-adjusted life-year in overweight patients, $18 716 per quality-adjusted life-year in patients with mild obesity, $10 274 per quality-adjusted life-year in patients with moderate obesity, and $6563 per quality-adjusted life-year in patients with severe obesity. Meaning Bariatric surgery could be highly cost-effective in patients with nonalcoholic steatohepatitis and compensated cirrhosis, even in those with a lower baseline body mass index.

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Psy23 Cost-Effectiveness of Laparoscopic Adjustable Gastric Banding and Laparoscopic Roux-en-Y Gastric Bypass in the Treatment of Morbid Obesity

Cited by 6 publications

References 0 publications

Obesity-related costs and the economic impact of laparoscopic adjustable gastric banding procedures: benefits in the Texas Employees Retirement System

Obesity-related costs and the economic impact of laparoscopic adjustable gastric banding procedures: benefits in the Texas Employees Retirement System

Estimated Cost-effectiveness of Medical Therapy, Sleeve Gastrectomy, and Gastric Bypass in Patients With Severe Obesity and Type 2 Diabetes

Cost-effectiveness Analysis of Bariatric Surgery for Patients With Nonalcoholic Steatohepatitis Cirrhosis

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