The Effect of Roux-en-Y Gastric Bypass on Prescription Drug Costs

Snow, L. L.; Weinstein, L. S.; Hannon, J. K.; Lane, Daniel R; Ringold, Forrest; Hansen, Peggy A; Pointer, Michael D.

doi:10.1381/0960892041975677

Cited by 41 publications

(46 citation statements)

References 18 publications

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“…These results showed an important reduction in the number of drugs used by patients submitted to the surgery and an increase in use of drugs by those treated clinically and with this result we can speculate that the NS group had an aggravation of the co-morbidities. As in our study, Nguyen et al 22 and Snow et al 23 also showed a significant decrease (92 and 66.7%, respectively) in the number of drugs used by patients to treat their co-morbidities and associated with that finding, the costs of CT decline after the RYGB.…”

Section: Discussionsupporting

confidence: 86%

Metabolic syndrome resolution by Roux-en-Y gastric bypass in a real world: a case control study

Schmid

Neto

Dias

et al. 2015

Rev. Assoc. Med. Bras.

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Metabolic syndroMe resolution by roux-en-y gastric bypass in a real world: a case control study rev assoC med bras 2015; 61 (2) Conflict of interest: noneObjectives: the aim of this study was to evaluate the efficacy of Roux-en-Y Gastric Bypass (RYGB), compared with nonsurgical treatment (NS group), as an instrument for inducing remission of co-morbidities related to Metabolic Syndrome (MetS) in patients with Obesity, grades 2 and 3 (Ob2,3). Methods: two hundred and fifty eight Ob2,3 patients were selected in a retrospective analysis and included in a case control study. MetS was defined as described by the International Diabetes Federation. One hundred and twenty-nine of these patients underwent RYGB (S group), and 129 were assessed as an NS group. Results: at baseline, S and NS groups did not differ in BMI, age, female sex and prevalence of MetS (p>0.05). For the S group the outcomes were a reduction in BMI of 38.1% (p<0.001), waist circumference of 28.6% (p<0.001), fasting plasma glucose of 10.5% (p<0.001), serum LDL-cholesterol of 21.9% (p<0.001) and of 85% in the number of patients with MetS (p<0.001). For the NS group, only a decrease of 4.12%(p=0.047) in triglyceride levels and of 5.9%(p=0.031) in Diastolic Blood Pressure was observed. In the NS group, 98.6% of the patients continued to have MetS. The number needed to treat (NNT) with surgery to resolve one case of MetS was 1.2 (CI 95%: 1.1 -1.4). Conclusion: in the real world, in the South of Brazil, compared with NS treatment and after 1 year of observation, RYGB is highly effective for decreasing the prevalence of MetS.

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Section: Discussionsupporting

confidence: 86%

Metabolic syndrome resolution by Roux-en-Y gastric bypass in a real world: a case control study

Schmid

Neto

Dias

et al. 2015

Rev. Assoc. Med. Bras.

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“…For example, Snow and others 57 observed a mean reduction of 2.7 drugs per patient, with a corresponding 72% mean reduction in drug cost, 2 years after Roux-en-Y gastric bypass. Malone and Alger-Mayer 58 investigated specific drug class changes 1 year after Roux-en-Y gastric bypass and found significant reductions in the use of antidiabetic (insulin, sulfonylureas, and metformin), antihypertensive (calcium-channel blockers, angiotensin-converting enzyme inhibitors or receptor blockers, and diuretics), and lipid-lowering medications.…”

Section: Discussionmentioning

confidence: 99%

Rapid Reduction in Use of Antidiabetic Medication after Laparoscopic Sleeve Gastrectomy: The Newfoundland and Labrador Bariatric Surgery Cohort (BaSCo) Study

Dillon

Peddle

Twells

et al. 2015

CJHP

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“…25 The reduction in drug use expected after the intervention was 49%. Considering the probability that some patients would be lost from the follow-up, it was decided to increase the sample size by 30%.…”

Section: -24mentioning

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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The Effect of Roux-en-Y Gastric Bypass on Prescription Drug Costs

Abstract: Weight loss resulting from LRYGBP significantly reduces obesity-related morbidities, resulting in a substantial reduction in medication needs in patients over the age of 54. The projected cost savings realized in the 78 patients in this study amounts to approximately $240,566.04 annually.

Cited by 41 publications

References 18 publications

Metabolic syndrome resolution by Roux-en-Y gastric bypass in a real world: a case control study

Metabolic syndrome resolution by Roux-en-Y gastric bypass in a real world: a case control study

Rapid Reduction in Use of Antidiabetic Medication after Laparoscopic Sleeve Gastrectomy: The Newfoundland and Labrador Bariatric Surgery Cohort (BaSCo) Study

Medication and nutritional supplement use before and after bariatric surgery

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