Cost-effectiveness of bariatric surgery in adolescents with severe obesity in the UK

Evidence shows that surgery for severe obesity in adults improves health and psychological functioning, and is cost-effective. Data on bariatric surgery for adolescents with severe obesity are extremely limited, with no evidence on cost-effectiveness. We evaluated the lifetime cost-effectiveness of bariatric surgery compared with no surgery in adolescents with severe obesity from the UK's National Health Service perspective. Eighteen adolescents with body mass index >= 40kg m(-2) who underwent bariatric surgery (laparoscopic Roux en Y Gastric Bypass [RYGB] [N = 9], and laparoscopic Sleeve Gastrectomy [SG] [N = 9]) at University College London Hospitals between January 2008 and December 2013 were included. We used a Markov cohort model to compare the lifetime expected costs and quality-adjusted life years (QALYs) between bariatric surgery and no surgery. Mean cost of RYGB and SG procedures were 7100 pound and 7312 pound, respectively. For RYGB vs. no surgery, the incremental cost/QALY was 2018 pound (95% CI 1942 pound - 2042) pound for males and 2005 pound (95% CI 1974 pound 2031) pound for females. For SG vs. no surgery, the incremental cost/QALY was 1978 pound (95% CI 1954 pound - 2002) pound for males and 1941 pound (95% CI 1915 pound - 1969) pound for females. Bariatric surgery in adolescents with severe obesity is cost-effective; it is more costly than no surgery however it markedly improved quality of life.