Long Term Cost of Obesity Management: Bariatric Surgery vs. Nonsurgical Approach

Thursday, September 15, 2022

3:30 PM – 3:40 PM East Coast USA Time

Location: JW Grand Ballroom 5-6

Reference 1: Boyers D, Retat L, Jacobsen E, et al. Cost-effectiveness of bariatric surgery and non-surgical weight management programmes for adults with severe obesity: a decision analysis model. Int J Obes (Lond). 2021;45(10):2179-2190. doi:10.1038/s41366-021-00849-8
Reference 2: Alsumali A, Eguale T, Bairdain S, Samnaliev M. Cost-effectiveness analysis of bariatric surgery for morbid obesity. Obes Surg. 2018;28(8):2203-2214. doi:10.1007/s11695-017-3100-0
Reference 3: Xia Q, Campbell JA, Ahmad H, Si L, de Graaff B, Palmer AJ. Bariatric surgery is a cost-saving treatment for obesity-A comprehensive meta-analysis and updated systematic review of health economic evaluations of bariatric surgery. Obes Rev. 2020;21(1):e12932. doi:10.1111/obr.12932

Primary Presenter(s)

Anthony Sciuva, Student

OMS III
PCOM South Georgia
PCOM South Georgia

Disclosure(s): No financial relationships to disclose

Author(s)

DJ

Daaniya Jamal, OMS-IV

PCOM South Georgia

Disclosure information not submitted.
KB

Kathleen Mae U. Bryan

Osteopathic Medical Student
Philadelphia College of Osteopathic Medicine - South Georgia Campus

Disclosure information not submitted.
SS

Shivani Sookchand, OMS-IV

PCOM South Georgia

Disclosure information not submitted.
GG

Geossette Garcia, OMS-IV

PCOM South Georgia

Disclosure information not submitted.

Disclosure(s):

Anthony Sciuva, Student: No financial relationships to disclose

Introduction/Purpose: Over the last several decades, obesity has become an epidemic increasing health care costs exponentially across the globe. Advances in medical technology have prolonged lifespan and thus increase the risk of developing several comorbidities and subsequent complications of obesity over time, such as diabetes. Projected cost estimates for the management of diabetes worldwide show an increase of 0.4% of the global GDP in the next eight years. Bariatric surgeries are a tool to manage this epidemic and have historically resulted in an increase in the length and quality of life for patients. There is evidence of decreased costs and incidences associated with the management of comorbidity complications for patients who have undergone bariatric surgery. This review evaluates the cost-effectiveness and benefit of bariatric surgery compared to that of non-surgical management of obesity and its associated chronic diseases.

Methods or Case Description:
Utilizing PUBMED, MEDLINE, and Google Scholar, a holistic review was conducted to identify research abstracts reporting costs and economic burdens for both bariatric surgery and commonly associated comorbidities of obesity. The research publications range from the years 2000 to 2022 with no restrictions in language or country of publication. Most studies reported direct and indirect costs at a country’s economic level or the direct cost to the individual patient.

Outcomes:
The total associated costs of bariatric surgery compared to the non-surgical management of obesity show a direct correlation with increased quality-adjusted-life-years (QALY). In some cases, the data show a near doubling of QALY for surgical compared to non-surgical management, 41.59 years and 23.40 years, respectively. Bariatric surgery decreased costs to patients in a span of 5 years by almost $6,000 annually. Patients who develop chronic conditions such as heart disease may experience even greater costs of over $100,000 with increased chances of morbidity in the short term, sometimes as high as 72% in some cohorts within five years of diagnosis. The management of both chronic illnesses like type-2 diabetes along with cardiovascular diseases results in direct patient costs ranging from $7,386-$16,872, which is further compounded by the increased healthcare demand on hospitals and healthcare staff.

Conclusion:
The data throughout the literature support that bariatric surgery increases the quality of life for patients and decreases the direct expenditures associated with the non-surgical management of obesity. While several cohort studies demonstrate a short-term improvement in QALY, additional studies are needed to elucidate the long-term impact of bariatric surgery. Some areas for additional investigation include the long-term costs associated with chronic management of bariatric candidates who have refused surgery, the direct costs to patients with and without insurance, and direct and indirect costs to health care facilities comparing hospitals to clinics for all cases of patients who refused bariatric surgery.
Learning Objectives:
Identify the relative costs associated with bariatric surgery management
Identify the estimated costs associated with nonsurgical management of obesity
Describe the costs associated with surgical management and non-surgical management of bariatric surgery