Cost-Effectiveness of Bariatric Surgery in Patients Living with Obesity and Type 2 Diabetes

J Diabetes Res. 2023 Dec 16:2023:9686729. doi: 10.1155/2023/9686729. eCollection 2023.

Abstract

Aims: The favourable effects of bariatric surgeries on body weight reduction and glucose control have been demonstrated in several studies. Additionally, the cost-effectiveness of bariatric surgeries has been confirmed in several analyses. The aim of the current analysis was to demonstrate the cost-effectiveness of bariatric surgeries in obese patients with type 2 diabetes in Hungary compared to conventional diabetes treatments based on economic modelling of published clinical trial results.

Materials and methods: Patients entered the simulation model at the age of 45 with body mass index (BMI) ≥ 30 kg/m2 and type 2 diabetes. The model was performed from the public payer's perspective, comparing sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) procedures to conventional care of diabetes. The results were provided separately for three BMI categories.

Results: The base-case analysis demonstrated that both surgery types were dominant; i.e., they saved 17 064 to 24 384 Euro public payer expenditures and resulted in improved health outcomes (1.36 to 1.50 quality-adjusted life years gain (QALY)) in the three BMI categories. Bariatric surgeries extended the life expectancy and the disease-free survival times of all the investigated diabetes complications. All the scenario analyses confirmed the robustness of the base-case analysis, such that bariatric surgeries remained dominant compared to conventional diabetes treatments.

Conclusion: The results of this cost-effectiveness analysis highlight the importance of bariatric surgeries as alternatives to conventional diabetes treatments in the obese population. Therefore, it is strongly recommended that a wider population has access to these surgeries in Hungary.

MeSH terms

  • Bariatric Surgery*
  • Cost-Benefit Analysis
  • Cost-Effectiveness Analysis
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / surgery
  • Gastrectomy / methods
  • Gastric Bypass* / methods
  • Humans
  • Obesity / complications
  • Obesity / surgery
  • Obesity, Morbid* / surgery
  • Retrospective Studies
  • Treatment Outcome