Bariatric Surgery: Shedding the Monetary Weight of Prescription Costs in the Managed Care Arena

Potteiger, Chad E.; Paragi, Prakash R.; Inverso, Nicholas A.; Still, Christopher D.; Reed, Mary Jane; Strodel, William E.; Rogers, Marc J.; Petrick, Anthony

doi:10.1381/0960892041590999

Cited by 55 publications

(45 citation statements)

References 23 publications

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“…It also confirms the decrease in postsurgical costs of outpatient pharmacy as reported by others [16,26,27]. Like other reports, it suggests that bariatric surgery is costeffective [12-14, 28, 29].…”

Section: Discussionsupporting

confidence: 88%

The Cost, Quality of Life Impact, and Cost–Utility of Bariatric Surgery in a Managed Care Population

et al. 2010

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Our purpose was to assess the cost, quality of life impact, and the cost-utility of bariatric surgery in a managed care population. We studied 221 patients who underwent bariatric surgery between 2001 and 2005. We analyzed medical claims data for all patients and survey data for 122 survey respondents (55% response rate). Patients were generally middle-aged, female, and white. Sixty-four percent underwent open and 33% underwent laparoscopic Roux-en-Y procedures. One year after surgery, mean body mass index fell from 51 to 31 kg/m(2) in women and from 59 to 35 kg/m(2) in men with substantial improvements in comorbidities. Postsurgical mortality and morbidity were low. Total per member per month costs increased in the 6 months before bariatric surgery, were lower in the 12 months after bariatric surgery, but increased somewhat over the next 12 months. When presurgical quality of life was assessed prospectively, average health utility scores improved by 0.14 one year after surgery. In analyses that took a lifetime time horizon, projected future costs based on age and obesity and discounted costs and health utilities at 3% per year, the cost-utility ratio for bariatric surgery versus no surgery was approximately $1,400 per quality-adjusted life-year gained. In sensitivity analyses, bariatric surgery was more cost-effective in women, non-whites, more obese patients, and when performed laparoscopically. Although not cost-saving, bariatric surgery represents a very good value for money. Its long-term cost effectiveness appears to depend on the natural history and cost of late postsurgical complications and the natural history and cost of untreated morbid obesity.

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Section: Discussionsupporting

confidence: 88%

The Cost, Quality of Life Impact, and Cost–Utility of Bariatric Surgery in a Managed Care Population

et al. 2010

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“…Maciejewski et al 26 reported that there was a 50% reduction in the use of antidiabetic drugs within one year after bariatric surgery. Additionally, Potteiger et al 27 and Narbro et al 28 reported that there were significant reductions in the numbers and cost of drugs used to treat diabetes relating to obesity, after surgery. Importantly, the features of the population and the follow-up period need to be taken into account in assessing these proportions, because the impact of surgery on antidiabetic drug use may vary according to these factors.…”

Section: Antidiabetic Drugsmentioning

confidence: 99%

“…45,46 Regarding the reduction in the number of patients who were using antihypertensive drugs, our findings were similar to those reported by other authors. [26][27][28]47,48 Partial or complete improvement was shown within 12 months after undergoing bariatric surgery, especially among the patients who had undergone gastric bypass, 10,47 thus reducing the need for antihypertensive drugs. 49,50 It seems again that our results were somehow related to the technique used for the majority of our patients, i.e.…”

Section: Antihypertensive Drugsmentioning

confidence: 99%

Medication and nutritional supplement use before and after bariatric surgery

Backes

Lopes²,

Tetelbom

et al. 2016

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Bariatric surgery has been an effective alternative treatment for morbid obesity and has resulted in decreased mortality, better control over comorbidities and reduced use of drugs. The objective of this study was to analyze the impact of bariatric surgery on medication drug and nutritional supplement use. DESIGN AND SETTING: Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. METHODS: Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated. RESULTS: Among the 69 patients interviewed, 85.5% had comorbidities in the preoperative period, with an average of 2.3 (± 1.5) per patient. The main comorbidities reported were hypertension, diabetes and dyslipidemia. 84.1% of the patients were using prescribed drugs in the preoperative period. The mean drug use per patient was 4.8, which decreased to 4.4 after the procedure. The surgery enabled significant reduction in use of most antidiabetic (84%), antilipemic (77%) and antihypertensive drugs (49.5%). On the other hand, there was a significant increase in use of multivitamins and drugs for disorders of the gastrointestinal tract. The dosages of most of the drugs that continued to be prescribed after surgery were decreased, but not significantly. CONCLUSION: After bariatric surgery, there were increases in the use of vitamins, gastric antisecretory drugs and antianemic drugs. Nevertheless, there was an overall reduction in drug use during this period, caused by suspension of drugs or dose reduction. RESUMO CONTEXTO E OBJETIVO:A cirurgia bariátrica tem sido uma alternativa efetiva de tratamento para a obesidade mórbida, resultando na diminuição da mortalidade, melhor controle das comorbidades e redução no uso de medicamentos. O objetivo deste estudo foi analisar o impacto da cirurgia bariátrica sobre a utilização de medicamentos e suplementos nutricionais. TIPO DE ESTUDO E LOCAL: Estudo longitudinal do tipo antes e depois com 69 pacientes obesos mórbi-dos em um hospital público de Porto Alegre. MÉTODOS: Nas entrevistas, foram avaliados a presença de comorbidades e o uso de medicamentos com e sem prescrição médica. RESULTADOS: De 69 pacientes entrevistados, 85,5% apresentaram comorbidades no período pré-cirúrgi-co, média de 2,3 (± 1,5) por paciente. As principais comorbidades relatadas foram hipertensão, diabetes e dislipidemias. 84,1% dos pacientes estavam em uso de medicamentos sob prescrição médica, no período pré-cirúrgico. A média de uso de medicamentos por paciente foi de 4,8, reduzindo para 4,4 após o procedimento. A cirurgia proporcionou diminuição significativa do uso da maioria dos antidiabéticos (84%), antilipêmicos (77%) e anti-hipertensivos (49,5%). Por outro lado, observou-se aumento significativo na utilização de multivitamínicos e medicamentos para desordens do trato gastrointestinal. A maior parte dos medicamentos que continuaram sendo prescritos após a cirurgia teve sua dose reduzida, no entanto, esta redução nã...

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“…1 The high morbidity rate is costly, both for the individual and the health-care system. [2][3][4] Weight loss improves or resolves the co-morbidities. 5,6 Bariatric surgery, by restrictive or malabsorptive methods, is the only treatment sustaining weight loss.…”

Section: Introductionmentioning

confidence: 99%

A Rat Model of Restrictive Bariatric Surgery with Gastric Banding

Monteiro¹,

Monteiro²,

Águas³

et al. 2006

obes surg

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Background: Gastric banding is a well established weight reduction operation that is effective in the treatment of severe obesity. Its metabolic and endocrine mechanisms of action, however, remain unclear. The aim of this study was to establish a rat model of gastric banding that would replicate the procedure performed in human obese patients.Methods: Male Wistar rats were submitted either to gastric banding (n=5) or sham gastric banding (n=4), and were followed for 21 days. Detailed description on how to perform gastric banding in rats are herein described.Results: The Wistar rats submitted to gastric banding showed a decrease in weight gain and food intake when compared to sham-operated rats.The cumulative weight gain during the 21 days after the surgical procedure was 143 ± 2.58 g for the gastric banded rats and 162 ± 2.48 g for the sham-operated animals (P=0.001). The cumulative food intake was 329 ± 0.53 g for the gastric banded rats and 380 ± 15.22 g for the sham-operated animals, also statistically significant (P=0.025).Conclusion: A rat model to study gastric banding is described. This model can now be used for experimental investigation of biochemical and molecular mechanisms of weight loss resulting from this type of surgery.

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Bariatric Surgery: Shedding the Monetary Weight of Prescription Costs in the Managed Care Arena

Abstract: RYGBP can decrease the prescription medication requirements, resulting in significant cost-savings in the treatment of obesity-related hypertension and diabetes. This study found a 77.3% reduction in total cost of diabetic and anti-hypertensive medications.

Cited by 55 publications

References 23 publications

The Cost, Quality of Life Impact, and Cost–Utility of Bariatric Surgery in a Managed Care Population

The Cost, Quality of Life Impact, and Cost–Utility of Bariatric Surgery in a Managed Care Population

Medication and nutritional supplement use before and after bariatric surgery

A Rat Model of Restrictive Bariatric Surgery with Gastric Banding

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