Cost comparison of patients undergoing bariatric procedures compared with controls
| Author/year/country/type of cost | Procedure | Economic data | No of surgical subjects | No of control subjects | Time period (years) | Cost comparison (surgical patients vs controls) |
|---|---|---|---|---|---|---|
| Näslund22 1991, Sweden (indirect cost) | RYGB, AGB, VBG | Questionnaire data | 79 | 54 | 5 | Higher employment, more working hours, fewer sick days and a higher income. Less medical care and higher quality of life |
| Martin23 1995, USA (direct cost) | RYGB | Cost per pound (lb) of weight loss analysis | 201 | 161 (very low calorie diet) | 6 | £500/lb vs £1000/lb |
| Narbro24 1999, Sweden (indirect cost) SOS Study | RYGB, AGB, VBG | Sick leave and disability pension analysis | 369 | 371 | 4 | Days of sickness tended to be lower in the surgical group (p=0.07) |
| Narbro25 2002, Sweden (direct cost) SOS Study | RYGB, AGB, VBG | Medication cost comparison | 510 | 455 | 6 | £80 vs £66 combined medication cost for diseases (per year). Although the relative drop in medication costs for the surgical candidates was much larger than controls. |
| Agren26 2002, Sweden (direct cost) SOS Study | RYGB, AGB, VBG | Cost comparison | 481 | 481 | 6 | There were no significant differences between the groups in number of hospital days or hospitalisation costs. |
| Agren27 2002, Sweden (direct cost) SOS Study | RYGB, AGB, VBG | Medication cost comparison | 279 (≥15% weight loss) | 410 (<5% weight loss) | 6 | £42 vs £87 combined medication cost for diabetes and cardiovascular disease (per year). |
| Gallagher28 2003, USA (direct cost) | RYGB | Cost comparison | 25 | 25 preoperative patients | 1 | £1800 vs £7000 (per year) |
| Sampalis29 2004, Canada (direct cost) | RYGB, VBG | Insurance utilisation costs | 1035 | 5746 | 5 | £12 vs £15.6 million per 1000 patients (cumulative) |
| Cost recovery from surgery at 3.5 years | ||||||
| Cremieux30 2008, USA (direct cost) | RYGB, AGB, VBG | Insurance utilisation costs | 3651 | 3651 | 4 | Cost recovery from surgery at 2–4 years |
| Makary31 2010, USA (direct cost) | RYGB, AGB, VBG, BPD | Insurance utilisation costs for diabetic medications | 2235 (type 2 diabetic patients) | 2235 (type 2 diabetic patients) preoperative patients | 3 | £2800 vs £4100 (per year). |
| Klein32 2010, USA (direct cost) | RYGB, AGB, VBG | Insurance utilisation costs | 808 (type 2 diabetic patients) | 808 (type 2 diabetic patients) | 3 | Cost recovery from surgery at 2.16 years |
| Office of Health Economics2 2010, UK (direct cost) | RYGB, AGB, SG | Economic model | Estimated 11 000–140 000 eligible for surgery | Estimated 11 000–140 000 (not receiving surgery) | 3 | If 5% undergo surgery: saving for first 3 years = £382 million |
| If 25% undergo surgery: saving for first 3 years = £1295 million | ||||||
| Cost recovery from surgery at 1 year | ||||||
| Finkelstein33 2011, USA (direct cost) | AGB | Insurance utilisation costs | >7000 | >7000 | 4 | £12 500 cost in the 90 days before and after the procedure |
| Cost recovery from surgery at just >2 years (diabetics) | ||||||
| Cost recovery from surgery at 4 years (non-diabetics) |
All costs converted to UK pounds in January 2011.
AGB, adjustable gastric banding; RYGB, Roux-en-Y gastric bypass; VBG, vertical banded gastroplasty.