Cost–utility of bariatric surgery for morbid obesity in Finland

Mäklin, Suvi; Malmivaara, Antti; Linna, Miika; Victorzon, Mikael; Koivukangas, Vesa; Sintonen, Harri

doi:10.1002/bjs.7640

Cited by 51 publications

(67 citation statements)

References 71 publications

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“…The true economic costs of bariatric surgery are therefore likely to be higher than have so far been reported, as most analyses to date have failed to account for the need for subsequent surgery with a few exceptions [9,10]. The only economic evaluation that does address this issue assigned the same probability for reoperation after all procedures [11].…”

Section: Introductionmentioning

confidence: 91%

Re-operations after Secondary Bariatric Surgery: a Systematic Review

et al. 2016

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This paper reviews reoperations rates for short- and long-term complications following secondary bariatric procedures and need for further bariatric surgery. The search revealed 28 papers (1317 secondary cases) following at least 75 % of patients for 12 months or more. For adjustable gastric banding (AGB), rebanding had higher re-revisional rates than conversions into other procedures. Conversion of AGB to Roux-en-Y gastric bypass had the highest number of short- (10.7 %) and long-term (22.0 %) complications. We estimated 194 additional reoperations per 1000 patients having a secondary procedure, 8.8 % needing tertiary surgery. Despite being poorly reported, risks of reoperations for long-term complications and tertiary bariatric surgery are higher than usually reported risks of short-term complications and should be taken into account when choosing a secondary bariatric procedure and for economic evaluations.

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Section: Introductionmentioning

confidence: 91%

Re-operations after Secondary Bariatric Surgery: a Systematic Review

et al. 2016

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“…Moreover, a growing literature associates bariatric surgery with reduced health care costs [4–7]. Postoperative outcomes, however, vary [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Emotional Eating: A Virtually Untreated Risk Factor for Outcome Following Bariatric Surgery

Chesler

2012

The Scientific World Journal

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Empirical investigations implicate emotional eating (EE) in dysfunctional eating behavior such as uncontrolled overeating and insufficient weight loss following bariatric surgery. They demonstrate that EE may be a conscious or reflexive behavior motivated by multiple negative emotions and/or feelings of distress about loss-of-control eating. EE, however, has not been targeted in pre- or postoperative interventions or examined as an explanatory construct for failed treatment of dysfunctional eating. Three cases suggest that cognitive behavioral treatment (CBT) might alleviate EE. One describes treatment for distress provoked by loss-of-control eating. The first of two others, associated with negative emotions/life situations, link treatment of a super-super-preoperative obese individual's reflexive EE with 52% excess BMI (body mass index) loss maintained for the past year, 64 months after surgery. The second relates treatment of conscious/reflexive EE with 84.52% excess BMI loss 53 months after surgery. Implications for research and treatment are discussed.

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“…Direct cost savings following BMS result from the reduced prevalence and severity of comorbid conditions which, in turn, translate into reduced comorbid condition medication costs, and reduced healthcare resource utilization. Surgical intervention has been associated with net cost savings compared with nonsurgical obesity care due to improved resolution of obesity-related comorbid conditions [47][48][49][50]. Significant reductions in both short-and long-term medication costs have also been shown [37,[51][52][53][54][55][56].…”

Section: Brief Overview Of Economic Evidence Of Bmsmentioning

confidence: 99%

“…Significant reductions in both short-and long-term medication costs have also been shown [37,[51][52][53][54][55][56]. Long-term, BMS has been shown to be less costly (1.5-fold lower) and more clinically effective than standard care over a 10-year span [47], and more costsaving over a 5-year period than standard medical management of diabetes (diet, exercise, and pharmaceutical therapy) [56].…”

Section: Brief Overview Of Economic Evidence Of Bmsmentioning

confidence: 99%

Gap Between Evidence and Patient Access: Policy Implications for Bariatric and Metabolic Surgery in the Treatment of Obesity and its Complications

et al. 2015

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Despite consistently supportive evidence of clinical effectiveness and economic advantages compared with currently available non-surgical obesity treatments, patient access to bariatric and metabolic surgery (BMS) is impeded. To address this gap and better understand the relationship between value and access, the objectives of this study were twofold: (i) identify the multidimensional barriers to adoption of BMS created by clinical guidelines, public policies, and health technology assessments; and, most importantly, (ii) develop recommendations for stakeholders to improve patient access to BMS. Updated public policies focused on treatment and clinical guidelines that reflect the demonstrated advantages of BMS, patient education on safety and effectiveness, updated reimbursement policies, and additional data on long-term BMS effectiveness are needed to improve patient access.

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Cost–utility of bariatric surgery for morbid obesity in Finland

Abstract: Surgery for morbid obesity increases health-related quality of life, and reduces the need for further treatments and total healthcare costs. According to this analysis, non-operative care would be more costly for the Finnish healthcare system on average after 5 years following surgery.

Cited by 51 publications

References 71 publications

Re-operations after Secondary Bariatric Surgery: a Systematic Review

Re-operations after Secondary Bariatric Surgery: a Systematic Review

Emotional Eating: A Virtually Untreated Risk Factor for Outcome Following Bariatric Surgery

Gap Between Evidence and Patient Access: Policy Implications for Bariatric and Metabolic Surgery in the Treatment of Obesity and its Complications

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