The real-world cost-effectiveness of bariatric surgery for the treatment of severe obesity: a cost-utility analysis.
CMAJ Open
; 9(2): E673-E679, 2021.
Article
em En
| MEDLINE
| ID: mdl-34145050
ABSTRACT
BACKGROUND:
Severe obesity is associated with adverse health outcomes and increased risk of death. This study evaluates the real-world cost-utility of therapy for severe obesity, from the publicly funded health care system and societal perspectives.METHODS:
We conducted a cost-utility analysis using primary data from a prospective observational cohort of adults living with severe obesity (BMI ≥ 35 kg/m2 and a major medical comorbidity or BMI ≥ 40 kg/m2) who were enrolled in a regional obesity program over 2 years. We extrapolated 10-year and lifetime Markov models, validated and supplemented with literature sources, to compare medical, surgical and standard care therapies. We performed deterministic and probabilistic sensitivity analyses.RESULTS:
The cohort included 500 adults living with severe obesity, 150 of whom received laparoscopic surgical therapy. From a publicly funded health system perspective, at 2 years, surgical therapy had an incremental cost-effectiveness ratio (ICER) of $54 456 per quality-adjusted life-year (QALY) compared with standard care therapy. Over a lifetime, it had an ICER of $14 056 per QALY. From the societal perspective, at 2 years, surgical therapy had an ICER of $340 per QALY; over a lifetime, it was the dominant option. The results were robust to sensitivity analysis.INTERPRETATION:
From a public health care perspective, surgery for severe obesity is cost effective, and when approached from a societal perspective, it becomes cost saving. Real-world data support using surgical therapy for severe obesity, and our results contribute to the health economic and clinical literature with regard to a robust analysis from a societal perspective.
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Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Obesidade Mórbida
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Saúde Pública
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Anos de Vida Ajustados por Qualidade de Vida
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Cirurgia Bariátrica
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article