J A Campbell1, A Venn1, A Neil1, M Hensher2, M Sharman1, A J Palmer1. 1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia. 2. Department of Health and Human Services, Hobart, Tasmania, Australia.
Abstract
BACKGROUND: Health economic evaluations inform healthcare resource allocation decisions for treatment options for obesity including bariatric/metabolic surgery. As an important advance on existing systematic reviews, we aimed to capture, summarize and synthesize a diverse range of economic evaluations on bariatric surgery. METHODS: Studies were identified by electronic screening of all major biomedical/economic databases. Studies included if they reported any quantified health economic cost and/or consequence with a measure of effect for any type of bariatric surgery from 1995 to September 2015. Study screening, data extraction and synthesis followed international guidelines for systematic reviews. RESULTS: Six thousand one hundred eighty-seven studies were initially identified. After two levels of screening, 77 studies representing 17 countries (56% USA) were included. Despite study heterogeneity, common themes emerged, and important gaps were identified. Most studies adopted the healthcare system/third-party payer perspective; reported costs were generally healthcare resource use (inpatient/shorter-term outpatient). Out-of-pocket costs to individuals, family members (travel time, caregiving) and indirect costs due to lost productivity were largely ignored. Costs due to reoperations/complications were not included in one-third of studies. Body-contouring surgery included in only 14%. One study evaluated long-term waitlisted patients. Surgery was cost-effective/cost-saving for severely obese with type 2 diabetes mellitus. Study quality was inconsistent. DISCUSSION: There is a need for studies that assume a broader societal perspective (including out-of-pocket costs, costs to family and productivity losses) and longer-term costs (capture reoperations/complications, waiting, body contouring), and consequences (health-related quality-of-life). Full economic evaluation underpinned by reporting standards should inform prioritization of patients (e.g. type 2 diabetes mellitus with body mass index 30 to 34.9 kg/m(2) or long-term waitlisted) for surgery.
BACKGROUND: Health economic evaluations inform healthcare resource allocation decisions for treatment options for obesity including bariatric/metabolic surgery. As an important advance on existing systematic reviews, we aimed to capture, summarize and synthesize a diverse range of economic evaluations on bariatric surgery. METHODS: Studies were identified by electronic screening of all major biomedical/economic databases. Studies included if they reported any quantified health economic cost and/or consequence with a measure of effect for any type of bariatric surgery from 1995 to September 2015. Study screening, data extraction and synthesis followed international guidelines for systematic reviews. RESULTS: Six thousand one hundred eighty-seven studies were initially identified. After two levels of screening, 77 studies representing 17 countries (56% USA) were included. Despite study heterogeneity, common themes emerged, and important gaps were identified. Most studies adopted the healthcare system/third-party payer perspective; reported costs were generally healthcare resource use (inpatient/shorter-term outpatient). Out-of-pocket costs to individuals, family members (travel time, caregiving) and indirect costs due to lost productivity were largely ignored. Costs due to reoperations/complications were not included in one-third of studies. Body-contouring surgery included in only 14%. One study evaluated long-term waitlisted patients. Surgery was cost-effective/cost-saving for severely obese with type 2 diabetes mellitus. Study quality was inconsistent. DISCUSSION: There is a need for studies that assume a broader societal perspective (including out-of-pocket costs, costs to family and productivity losses) and longer-term costs (capture reoperations/complications, waiting, body contouring), and consequences (health-related quality-of-life). Full economic evaluation underpinned by reporting standards should inform prioritization of patients (e.g. type 2 diabetes mellitus with body mass index 30 to 34.9 kg/m(2) or long-term waitlisted) for surgery.
Authors: Karen Jordan; Christopher G Fawsitt; Paul G Carty; Barbara Clyne; Conor Teljeur; Patricia Harrington; Mairin Ryan Journal: Eur J Health Econ Date: 2022-07-22
Authors: Brett Doble; Richard Welbourn; Nicholas Carter; James Byrne; Chris A Rogers; Jane M Blazeby; Sarah Wordsworth Journal: Obes Surg Date: 2019-02 Impact factor: 4.129
Authors: Julie A Campbell; Martin Hensher; Amanda Neil; Alison Venn; Petr Otahal; Stephen Wilkinson; Andrew J Palmer Journal: Pharmacoecon Open Date: 2018-12
Authors: Julie A Campbell; Martin Hensher; Daniel Davies; Matthew Green; Barry Hagan; Ian Jordan; Alison Venn; Alexandr Kuzminov; Amanda Neil; Stephen Wilkinson; Andrew J Palmer Journal: Pharmacoecon Open Date: 2019-12
Authors: Qing Xia; Julie A Campbell; Hasnat Ahmad; Barbara de Graaff; Lei Si; Petr Otahal; Kevin Ratcliffe; Julie Turtle; John Marrone; Mohammed Huque; Barry Hagan; Matthew Green; Andrew J Palmer Journal: Eur J Health Econ Date: 2021-11-12