Cost effectiveness of Bariatric Surgery

	67% of the Americans suffer from obesity and medical conditions such as diabetes due to obesity. Bariatric Surgeries for weight loss are very common these days. Some of the common procedures are as below
1. Laparoscopic gastric bypass (LRYGB)
2. Roux-en-Y gastric bypass (ORYGB)
3. Laparoscopic adjustable gastric banding (LAGB)

Patients often evaluate the risks of undergoing the weight loss surgery and its benefits and not much thought is given to the cost effectiveness of these surgeries. There are studies that show that weight loss surgeries are more cost effective when compared to the usual care for medical conditions like diabetes and medical care/surgery for problems that arise due to obesity such as knee surgeries etc.

A study analyses the cost-effectiveness of bariatric surgery in severely obese (BMI ≥35 kg/m2) adults who have diabetes. The model shows that the results from undergoing bariatric surgery include suppression of diabetes, reduction in diabetes complications and other risk factors which in turn increases the quality of life (Qol).But considering other factors such as pre-operative death, complications due to surgery and the post-operative risks (there may be a relapse of diabetes) a measure known as quality-adjusted life-years (QALYs) is used to determine the cost effectiveness.

In this study Laparoscopic Gastric Bypass surgery had cost-effectiveness ratios of $7,000/QALY and $12,000/QALY for severely obese patients with newly diagnosed and established diabetes, correspondingly. Laparoscopic Adjustable Gastric Banding surgery had cost-effectiveness ratios of $11,000/QALY and $13,000/QALY for the respective groups.

Another study done based on (BMI ≥44 kg/m2) adults showed that bariatric surgery produced additional life expectancy (80–81 years) compared to no surgery (78 years). The incremental cost-effectiveness ratios were $6,600 (QALY) for LRYGB, $ 6200 (QALY) for LAGB and $17,300 (QALY) for ORYGB.

These studies are useful inputs when a patient wants to undergo bariatric surgery. Patients should consider bariatric surgery as a last resort and should completely understand the risks and benefits before considering surgery.