Estimation of the cost savings resulting from the use of ursodiol for the prevention of gallstones in obese patients undergoing rapid weight reduction.
BACKGROUND
Morbidly obese patients enrolled in a rapid weight reduction program are at a high risk of developing gallstones. Two multicenter, placebo-controlled, randomized, double-blind trials have demonstrated that the prophylactic use of ursodiol in males and females 18 to 70 years of age is effective for the prevention of gallstone formation in this patient population. This study examines the cost consequences associated with the prophylactic use of ursodiol.


METHODS
A medical decision analysis model for the prophylactic administration of ursodiol in morbidly obese patients undergoing rapid weight reduction by either gastric bypass surgery or very-low-calorie-diet, was developed through the use of data from two clinical trials and review of the related literature. The expert opinion of clinicians from the fields of internal medicine, gastroenterology and surgery were solicited. Financial data for the charges associated with cholecystectomies, physician fees and ursodiol were obtained from current financial databases.


RESULTS
The model demonstrates that the prophylactic administration of ursodiol, in morbidly obese patients undergoing rapid weight reduction, results in cost savings. Sensitivity analysis was performed to illustrate that the cost savings achieved by the prophylactic use of ursodiol were valid over a realistic range of charges and assumptions.


CONCLUSIONS
The decision model may allow health care decision makers to apply their own data to the model to determine the cost savings obtainable through the prophylactic use of ursodiol in patients undergoing rapid weight reduction.
Shoheiber
O
O
Office of Health Policy and Clinical Outcomes, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Biskupiak
J E
JE
Nash
D B
DB
D000328:Adult; D000368:Aged; D002756:Cholagogues and Choleretics / Q000191:economics* / Q000627:therapeutic use; D002769:Cholelithiasis / Q000191:economics* / Q000209:etiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D004038:Diet, Reducing / Q000191:economics; D005260:Female; D015390:Gastric Bypass / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D014580:Ursodeoxycholic Acid / Q000191:economics* / Q000627:therapeutic use
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid