Raquel Sanchez-Santos1, Esther Mariño Padin2, Daniel Adam3, Oleg Borisenko3, Sergio Estevez Fernandez4, Ester Carrera Dacosta4, Sonia González Fernández2, Juan Turnes Vazquez5, Juan Carlos Ruiz de Adana6, Felipe de la Cruz Vigo7. 1. a General and Digestive Surgery Department , Complejo Hospitalario de Pontevedra, Instituto de Investigación Galicia Sur , Pontevedra , Spain. 2. b General and Digestive Surgery Department , Complejo Hospitalario de Pontevedra , Pontevedra , Spain. 3. c Health Economics Department , Synergus AB , Danderyd , Sweden. 4. d General and Digestive Surgery Department , Complejo Hospitalario Universitario de Pontevedra , Pontevedra , Spain. 5. e Digestive System Department , Instituo de investigación Galicia Sur , Pontevedra , Spain. 6. f Obesity Unit , Hospital Universitario de Getafe , Madrid , Spain. 7. g General and Digestive Surgery Department , Hospital Universitario 12 de Octubre , Madrid , Spain.
Abstract
BACKGROUND: We assessed the cost-effectiveness of bariatric surgery (BS) versus conservative management (CM) for treating morbid obesity in Spain. METHODS: We developed a probabilistic Markov model to estimate health outcomes, quality-adjusted life years (QALY), life years gained (LYG), and costs over lifetime and 10-year horizons. Combined common BS procedures were compared with CM. Clinical and utility inputs were obtained from the literature and resource use and costs from local sources (€2017). RESULTS: Over the 10-year horizon, BS led to a cost increment of €9,386 and 1.6 additional QALY (€5,966/QALY). Leading to 0.6 LYG and 4.4 QALY gains and €300/patient average cost savings over lifetime, BS could potentially significantly reduce diabetes and cardiovascular disease risk over the considered horizons. Despite short-term cost reductions, surgery delay may lead to significant clinical benefits loss. CONCLUSIONS: Compared to CM, BS is a more effective and less costly alternative for treating morbid obesity in Spain.
BACKGROUND: We assessed the cost-effectiveness of bariatric surgery (BS) versus conservative management (CM) for treating morbid obesity in Spain. METHODS: We developed a probabilistic Markov model to estimate health outcomes, quality-adjusted life years (QALY), life years gained (LYG), and costs over lifetime and 10-year horizons. Combined common BS procedures were compared with CM. Clinical and utility inputs were obtained from the literature and resource use and costs from local sources (€2017). RESULTS: Over the 10-year horizon, BS led to a cost increment of €9,386 and 1.6 additional QALY (€5,966/QALY). Leading to 0.6 LYG and 4.4 QALY gains and €300/patient average cost savings over lifetime, BS could potentially significantly reduce diabetes and cardiovascular disease risk over the considered horizons. Despite short-term cost reductions, surgery delay may lead to significant clinical benefits loss. CONCLUSIONS: Compared to CM, BS is a more effective and less costly alternative for treating morbid obesity in Spain.
Authors: Emma C Kearns; Naomi M Fearon; Pauric O'Reilly; Cian Lawton; Tim McMackin; Abigail M Walsh; Justin Geogheghan; Helen M Heneghan Journal: Obes Surg Date: 2021-01-08 Impact factor: 4.129
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