The Socio-economic Impact of Bariatric Surgery

Abstract

There are no cost savings of bariatric surgery in the short run. Further real-world evidence over a longer period of time is needed to examine whether the higher health care costs will eventually be counterbalanced, making bariatric surgery a profitable intervention in a socio-economic perspective.

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

“…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 ).…”

“…Therefore, of the remaining 61 studies included in our meta‐analyses, 34 (56%) and 27 (44%) were based on partial and full health economic evaluations, respectively.…”

“…We conducted three meta‐analytical comparisons namely (a) “before” versus “after” health care costs (n = 17 studies; yielding 19 comparisons); (b) medication cost changes from before versus after bariatric surgery (n = 20 studies; yielding 22 comparisons); and (c) surgical versus nonsurgical health care costs (n = 37 studies; yielding 58 comparisons) (Figure ). It was noteworthy that five out of n = 61 included studies simultaneously contained cost data for before versus after comparisons and surgical versus nonsurgical comparisons, and eight studies reported both health care costs and medication costs before and after surgery (Figure ).…”

“…Informed by a recent systematic review, indirect costs account for between 54% and 59% of the estimated total costs for people with obesity who did not undergo bariatric surgery, indicating that the ratio of direct costs to indirect costs was 4:6 . Additionally, substantial evidence has revealed that bariatric surgery could reduce impacts of indirect costs due to productivity losses (e.g., absenteeism, presenteeism, and early retirement), social transfer payments (e.g., disability pensions and unemployment benefits), and/or wage loss . In consideration of this evidence, we therefore used a ratio of 5:5 in Scenario 2 and a ratio of 6:4 in Scenario 3 for the bariatric surgical arm for our cumulative cost meta‐analytical model.…”

Real-world evidence of health outcomes and medication use 24 months after bariatric surgery in the public healthcare system in Brazil: a retrospective, single-center study

“…This might also be the case in other countries or healthcare systems where newer and more expensive drugs are employed. It is noteworthy that Kelles et al Moreover, as reported by Larsen et al (18), results on the ability of bariatric surgery to generate healthcare savings are inconsistent. In their study, the authors investigated the impact of bariatric surgery on healthcare costs, social transfer payments, and income in a surgical vs. nonsurgical group in 7 years (3 years preoperatively, year of surgery, and 3 years postoperative) in Denmark.…”