Estimated Costs of Clinical and Surgical Treatment of Severe Obesity in the Brazilian Public Health System

Abstract

Total costs were higher in the surgical group in the first 2 years after surgery. However, from the third year on, the costs were lower than in the clinical group.

Bariatric surgery is a cost‐saving treatment for obesity—A comprehensive meta‐analysis and updated systematic review of health economic evaluations of bariatric surgery

“…Since September 2015, n = 24 health economic evaluations regarding bariatric surgery (with comparison to conventional treatment/no surgery or “before” versus “after” comparison) have been published. The distribution of economic reporting was similar to our previous narrative review, with 10 (42%) from European countries (UK 4, Denmark 2, Belgium 1, Italy 1, Germany 1, and Spain 1), six (25%) from the USA, three (13%) from Brazil, two (8%) from Australia and New Zealand, one (4%) each from Canada, Turkey, and China . Of special note was that 21% of studies (five out of n = 24) derived from developing countries, with two of these studies informed by Asian cohorts …”

“…As an example, a Turkish cost‐consequences analysis concluded that the economic burden of surgery for patients with BMI ≥ 40 kg/m 2 was eliminated from the fourth year after the surgery . Similar results were shown in two other partial economic evaluations, and cost savings increased when indirect costs were considered . On the other hand, several partial health economic evaluations with a short‐term time horizon suggested that bariatric surgery raised the postoperative health care costs …”

“…After removing duplicate papers 1096 studies remained for title and abstract screening, with 63 studies included for full‐text review. Of these, 24 partial and full health economic evaluation studies were included in the updated systematic review . These studies were also assessed against the eligibility criteria for quantitative meta‐analyses together with the n = 77 eligible health economic evaluations from our previous systematic review (low part of Figure ).…”

“…Forty‐two percent of the included health economic evaluations (n = 10, and mainly partial health economic evaluations) adopted a short‐term time horizon (<10 years), and 70% (n = 7) of these studies reported results for ≤5 years . The majority of studies (n = 14, 58%) adopted a long‐term time horizon (≥10 years or lifetime); nevertheless, just one fifth (n = 3) of full health economic evaluations of bariatric surgery did not account for the cost of complications and reoperations after bariatric surgery .…”

“…The majority of studies (n = 14, 58%) adopted a long‐term time horizon (≥10 years or lifetime); nevertheless, just one fifth (n = 3) of full health economic evaluations of bariatric surgery did not account for the cost of complications and reoperations after bariatric surgery . On the other hand, two‐thirds (n = 6) of partial health economic evaluations failed to consider health care costs due to complications and/or reoperations following the primary bariatric surgical procedure …”