OBJECTIVE: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. METHODS: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. RESULTS: In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. CONCLUSION: In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis.
OBJECTIVE: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. METHODS: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. RESULTS: In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. CONCLUSION: In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis.
Authors: Lars Sjöström; Anna-Karin Lindroos; Markku Peltonen; Jarl Torgerson; Claude Bouchard; Björn Carlsson; Sven Dahlgren; Bo Larsson; Kristina Narbro; Carl David Sjöström; Marianne Sullivan; Hans Wedel Journal: N Engl J Med Date: 2004-12-23 Impact factor: 91.245
Authors: A Zanchetti; L Hansson; B Dahlöf; D Elmfeldt; S Kjeldsen; R Kolloch; P Larochelle; G T McInnes; J M Mallion; L Ruilope; H Wedel Journal: J Hypertens Date: 2001-06 Impact factor: 4.844
Authors: Brandi J Witt; Karla V Ballman; Robert D Brown; Ryan A Meverden; Steven J Jacobsen; Véronique L Roger Journal: Am J Med Date: 2006-04 Impact factor: 4.965
Authors: Philip A Poole-Wilson; Jacobus Lubsen; Bridget-Anne Kirwan; Fred J van Dalen; Gilbert Wagener; Nicolas Danchin; Hanjörg Just; Keith A A Fox; Stuart J Pocock; Tim C Clayton; Michael Motro; John D Parker; Martial G Bourassa; Anthony M Dart; Per Hildebrandt; Ake Hjalmarson; Johannes A Kragten; G Peter Molhoek; Jan-Erik Otterstad; Ricardo Seabra-Gomes; Jordi Soler-Soler; Simon Weber Journal: Lancet Date: 2004 Sep 4-10 Impact factor: 79.321
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: Sean Harrison; Padraig Dixon; Hayley E Jones; Alisha R Davies; Laura D Howe; Neil M Davies Journal: PLoS Med Date: 2021-08-27 Impact factor: 11.069
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