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Bariatric Surgery for the Treatment of Severely Obese Patients in South Korea—Is it Cost Effective?

Obesity Surgery volume 23, pages 2058–2067 (2013)Cite this article

Abstract

Background

In South Korea, the number of severely obese patients has increased. An economic study comparing bariatric surgery with nonsurgical interventions has not been published for Asia.

Objectives

This study was conducted to evaluate the cost effectiveness of bariatric surgery as compared to nonsurgical interventions for severe obese Korean people.

Methods

We used the Markov model to compare the lifetime expected costs and quality-adjusted life years (QALYs) between bariatric surgery and nonsurgical interventions from Korean Healthcare system perspectives. Our target cohort consisted of severe obese people defined as having a body mass index of 30–<40 kg/m2 in South Korea. The starting age of the cohort was 30 years old, and the cycle length was 1 year. Nonsurgical interventions included a physician visit, exercise, diet, and pharmacotherapy. A discount of 5 % was applied in cost and QALY. The incremental cost-effectiveness ratio (ICER) of bariatric surgery compared to nonsurgery interventions was calculated.

Results

The cost-utility analysis study indicated that bariatric surgery had US$1,522 incremental costs and 0.86 incremental QALYs as compared to nonsurgical interventions. Through the base case analysis, ICER was US$1,771/QALY. The sensitivity analyses were performed using a variety of assumptions, and the robustness of the study results was also demonstrated.

Conclusion

The study indicated that bariatric surgery was a cost-effective alternative to nonsurgical interventions over a lifetime, providing substantial lifetime benefits for severely obese Korean people.

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Acknowledgments

This study was completed as part of the health technology assessment report (project no. NA2011-003) funded by the NECA in Korea. The results of this project underwent the appraisal process involving orthopedist, family medicine specialists, methodologists, and governmental officials. No other sources of funding were used to assist in the preparation of this article. Hyun Jin Song, Jin Won Kwon, Yong Jin Kim, Sung-Hee Oh, Yoonseok Heo, and Sang-Moon Han have no conflicts of interest that are directly relevant to the content of this article.

Author information

Affiliations

  1. National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea

    Hyun Jin Song, Jin Won Kwon, Sung-Hee Oh & Yoonseok Heo

  2. School of Pharmacy, Sungkyunkwan University, Suwon, South Korea

    Hyun Jin Song

  3. College of Pharmacy, Kyungpook National University, Daegu, Korea

    Jin Won Kwon

  4. Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea

    Yong Jin Kim

  5. Department of Surgery, Inha University School of Medicine, Incheon, Korea

    Yoonseok Heo

  6. Department of Surgery, CHA University School of Medicine, Seoul, Korea

    Sang-Moon Han

  7. National Evidence-based Healthcare Collaborating Agency, Changkyung Building 4Fl, Wonnam-dong 28-7, Jongno-gu, 110-450, Seoul, Korea

    Yong Jin Kim

  8. Division of Surgery, Soonchunhyang University Hospital, Hannam-dong 657, Yongsan-gu, Seoul, 140-887, South Korea

    Yong Jin Kim

Authors
  1. Hyun Jin Song
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  2. Jin Won Kwon
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  3. Yong Jin Kim
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  4. Sung-Hee Oh
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  5. Yoonseok Heo
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  6. Sang-Moon Han
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Corresponding author

Correspondence to Yong Jin Kim.

Additional information

H.J. Song and J.W. Kwon contributed equally to this work.

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Song, H.J., Kwon, J.W., Kim, Y.J. et al. Bariatric Surgery for the Treatment of Severely Obese Patients in South Korea—Is it Cost Effective?. OBES SURG 23, 2058–2067 (2013). https://doi.org/10.1007/s11695-013-0971-6

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  • DOI: https://doi.org/10.1007/s11695-013-0971-6

Keywords

  • Bariatric surgery
  • Cost effectiveness
  • Obesity
  • Quality-adjusted life years
  • Cost–benefit
  • Analysis
  • Gastric bypass