New Research Says Surgery Cost-Effective and Cuts Drug Costs

New research published in the Journal of the American Medical Association found that obese patients who underwent weight loss surgery used fewer medications in the long term, especially drugs used for diabetes and cardiovascular disease. This reduction had a cost savings for surgery patients, compared to a control group receiving standard medical care. The study found that between years 7 and 20 post-operation, surgery patients paid on average $930 per year for drugs, while during the same period, patients in the control group paid on average $1,123 annually for drugs.

In terms of weight loss, the surgery group lost on average 17 percent of their body weight at 10 years. At year 15, their weight loss was maintained at about 16 percent and at year 20, average weight loss was 18 percent. In contrast, the control group gained 1 percent of their body weight by year 10, and lost 1 percent at years 15 and 20. While the study did not find an overall reduction in healthcare usage after surgery, the notable decrease in the long term drug costs highlights the effectiveness of bariatric surgery in improving obesity-related diseases, especially diabetes and cardiovascular disease.

New research presented at the 2012 annual meeting of The Obesity Society also highlighted the cost benefits of surgery. Dr. William Herman, Director of the Michigan Center for Diabetes Translational Research (MCDTR), presented data about the cost-effectiveness of gastric banding and gastric bypass surgery. Dr. Herman analyzed data from a total of 11 studies. He found that weight loss surgery in patients without diabetes was cost-effective in all of the six studies he reviewed. Surgery seemed to be more cost effective in women, in those who were more severely obese, and those who had obesity-related health conditions.

In patients with diabetes, surgery went beyond the measure of cost-effective, and was actually cost saving in three of the five studies analyzed. In the other two studies, Herman said bariatric surgery was “very cost-effective” for patients with diabetes. A limitation of the studies were that the follow-up was 4 years, and not longer. The results may be less favorable if patients put on weight over time, or if there are long term adverse events incurring additional costs. At the conclusion of the presentation, Dr. Herman said that he was “surprised to see how cost-effective bariatric surgery is and that we should probably be looking at ways to do more of it.”

We spoke with Dr. Kim Marley, expert weight loss surgeon in Pennsylvania, about the research. He said: “This study nicely demonstrates what we have seen and known for years. Not only does bariatric surgery improve overall health, but has the added bonus of cost savings. It is always rewarding to see my patients’ medical problems improve and have the medications go away. But they really like having the medication co-pays go away, as well.”

Last year a study looked at the cost-effectiveness of bariatric surgery and found that it is a cost-effective treatment for people who are mildly obese to severely obese. Using data from 170 studies and a metric called the quality-adjusted life year (QALY), researchers concluded that the cost of weight loss surgery is less than the medical costs associated with not having the surgery.  You can read more about the findings here.


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