Obesity Surgery

, Volume 24, Issue 12, pp 2061–2068 | Cite as

Cost–Utility Analysis of Gastric Bypass for Severely Obese Patients in Spain

  • Iván Castilla
  • Javier Mar
  • Cristina Valcárcel-Nazco
  • Arantzazu Arrospide
  • Juan M. Ramos-Goñi
Original Contributions



To assess the cost–utility of gastric bypass versus usual care for patients with severe obesity in Spain.


We have implemented a discrete-event simulation model with two branches: one branch involves gastric bypass, thereby reducing patients’ BMI, and another branch where patients do not undergo surgery. The model analyzes the emergence of comorbidities (stroke, coronary obstructive disease, diabetes, and breast cancer) associated with obesity during a lifetime horizon. The selected measure of effectiveness is health-related quality of life. Both costs and effects are discounted at 3 %. A probabilistic sensitivity analysis is also performed using second-order Monte Carlo simulation; acceptability curves for different time horizons were also calculated.


Patients with gastric bypass result in a lifetime increase of 5.63 quality-adjusted life years (QALYs) (18.18 vs. 12.55 QALYs). In addition, because of the reduced spending associated with the treatment of various obesity-related comorbidities, final savings stand at 13,994 €. The total cost of the intervention branch is close to half the cost of the non-intervention branch (17,431 vs. 31,425 €).


Gastric bypass is an intervention that dominates over the option of not intervening when a lifetime horizon is considered.


Cost–utility Discrete-event simulation Gastric bypass 



The authors acknowledge the Spanish Ministry of Health, Social Policy and Equality for their help as a funding source.

Conflict of Interest

I. Castilla has no conflict of interest.

J. Mar has no conflict of interest.

C. Valcárcel-Nazco has no conflict of interest.

A. Arrospide has no conflict of interest.

J.M. Ramos-Goñi has no conflict of interest.

Supplementary material

11695_2014_1304_MOESM1_ESM.docx (96 kb)
ESM 1 (DOCX 96 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Iván Castilla
    • 1
    • 2
    • 5
  • Javier Mar
    • 3
    • 4
  • Cristina Valcárcel-Nazco
    • 2
    • 5
  • Arantzazu Arrospide
    • 3
    • 4
  • Juan M. Ramos-Goñi
    • 1
    • 6
  1. 1.Health Services Research on Chronic Patients Network (REDISSEC)Santa Cruz de TenerifeSpain
  2. 2.Centre for Biomedical Research of the Canary IslandsUniversidad de La LagunaLa LagunaSpain
  3. 3.Health Services Research on Chronic Patients Network (REDISSEC)Santa Cruz de TenerifeSpain
  4. 4.Clinical Management ServiceAlto Deba HospitalMondragonSpain
  5. 5.Canary Islands Foundation for Health and Research (FUNCIS)Santa Cruz de TenerifeSpain
  6. 6.HTA Unit of the Canary Islands Health Service (SESCS)Santa Cruz de TenerifeSpain

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