Gastric Bypass is a Cost-Saving Procedure: Results from a Comprehensive Markov Model
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Obesity is a growing public health problem in industrialized countries and is directly and indirectly responsible for almost 10 % of all health expenditures. Bariatric surgery is the best available treatment, however, associated with important economical expenditures. So, cost-effectiveness analysis of the available surgical options is paramount.
We developed a Markov model for three different strategies: best medical management, gastric band, and gastric bypass. The Markov model was constructed to allow for the evaluation of the impact of several obesity-related comorbidities. The results were derived for a representative population of morbidly obese patients, and subgroup analyses were performed for patients without comorbidities, patients with diabetes mellitus, different age, and body mass index (BMI) groups. Cost-effectiveness analysis was performed accounting for lifetime costs and from a societal perspective.
Gastric bypass is a dominant strategy, rendering a significant decrease in lifetime costs and increase in quality-adjusted life years (QALYs). Comparing with the best medical management, in the global population of patients with a BMI of >35 kg/m2, gastric bypass renders 1.9 extra QALYs and saves on average 13,244€ per patient. Younger patients, patients with a BMI between 40 and 50 kg/m2, and patients without obesity-related diseases are the ones with a bigger benefit in terms of cost effectiveness.
Gastric bypass surgery increases quality-adjusted survival and saves resources to health systems. As such, it can be an important process to control the ever-increasing health expenditure.
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- Gastric Bypass is a Cost-Saving Procedure: Results from a Comprehensive Markov Model
Volume 23, Issue 4 , pp 460-466
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Obesity surgery
- Markov model
- Gastric bypass
- Industry Sectors
- Author Affiliations
- 1. Department of Surgery, Faculty of Medicine, University of Porto, Porto, Portugal
- 2. Department of Surgery, São João Medical Center, Porto, Portugal
- 3. Al. Prof. Hernani Monteiro, HSJ–Cirurgia Geral Piso 5, 4200-319, Porto, Portugal