Washington University Recent study: The Cost Effectiveness of Bariatric Surgery
A recent study conducted by the Washington University School of Medicine in St. Louis found that weight loss surgery is a cost-effective treatment for people who are mildly obese to severely obese. The study found that because people who undergo bariatric surgery are more likely to keep weight off in the long term, as well as suffer fewer health problems related to being obese, the weight loss surgery is a good value economically. The study also indicates that bariatric surgery ultimately saves money in healthcare costs for the most severely obese patients that suffer from diseases related to their weight, including heart disease, high blood pressure and Type 2 diabetes.
The study looked at the cost-effectiveness of surgery using a metric called the quality-adjusted life year (QALY). QALY measures the value of treatment in terms of one’s quality and length of life. In the United States, in order for a medical treatment to be considered cost effective, the limit is $50,000 – meaning that is assumed that a person would be willing to pay up to $50,000 for an additional year of a healthy life. Any cost less than the $50,000 is said to be cost-effective.
The researchers looked at data from 170 different studies, examining the effectiveness of weight loss surgery and estimated the life expectancies and quality of life of people who had bariatric surgery compared with people who did not. The average age of the patients was 39.5 years old. The life expectancy for all BMI groups after surgery was between 37.5 and 38.5 years. Life expectancy for those who did not undergo surgery was 5-6 years shorter, on average. For those with a BMI of 50 or greater, the cost per QALY is negative, meaning that the cost of weight loss surgery is less than the medical costs associated with not having the surgery. Second, for those with a BMI of 40-50, the cost per QALY is about $1,900 if the person has an obesity-related disease and about $3,800 for those who are healthy – both well below the limit of $50,000. Lastly, for the moderately obese (BMI of 35-40), the cost per QALY is only about $2,400 for those with related medical problems and $3,900 for those who are healthy.
We spoke with Dr. Marina Kurian, Medical Director of the NYU Weight Management Program about the findings. She told us that this is important because it helps to identify the benefits of weight loss surgery across Body Mass Index (BMI) categories. She explained “This particular study underscores the cost benefit of weight loss surgery for treatment of obesity: not only morbid obesity. It adds credence to the FDA approval of the lap band in lower BMI patients and it also adds more evidence to the benefit of surgery for lower BMI diabetics (30-35). Since 700 billion dollars will be spent on obesity in the next year, methods to decrease the cost should be carefully considered.”
Dr. Kurian added that “because we have shown that we can decrease the risks of weight loss surgery across the different stages of obesity with laparoscopy and improvements in technique and clinical protocols, offering surgery to lower BMI and obese patients is appropriate.”