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Expert Rev Pharmacoecon Outcomes Res. 2018 Jun;18(3):305-314. doi: 10.1080/14737167.2018.1407649. Epub 2017 Nov 30.

Bariatric surgery versus conservative management for morbidly obese patients in Spain: a cost-effectiveness analysis.

Author information

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.

KEYWORDS:

Bariatric surgery; Markov; Spain; cost-effectiveness; economic evaluation; obesity

PMID:
29188745
DOI:
10.1080/14737167.2018.1407649
[Indexed for MEDLINE]

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