Cost-utility analysis of bariatric surgery

BackgroundThe objective of the study was to evaluate the cost-utility of bariatric surgery in England. MethodsA state-transition Markov model was developed to compare the costs and outcomes of two treatment approaches for patients with morbid obesity: bariatric surgery, including gastric bypass, sleeve gastrectomy and adjustable gastric banding; and non-surgical usual care. Parameters of the effectiveness of surgery and complications were informed by data from the UK National Bariatric Surgery Registry, the Scandinavian Obesity Registry and the Swedish Obese Subjects study. Costs and utilities were informed by UK sources. ResultsBariatric surgery was associated with reduced mean costs to the health service by Euro2742 (1944), and gain of 08 life-years and 40 quality-adjusted life-years (QALYs) over a lifetime compared with usual care. Bariatric surgery also had the potential to reduce the lifetime risks of obesity-related cardiovascular diseases and diabetes. Delaying surgery for up to 3years resulted in a reduction of 07 QALYs and a minor decrease of Euro2058 (1459) in associated healthcare costs. ConclusionCurrently used surgical methods were found to be cost saving over the lifetime of individuals treated in England. Surgery cost-effective