A prospective cost-effectiveness analysis of vertical banded gastroplasty for the treatment of morbid obesity.
BACKGROUND
Surgical treatment of morbid obesity is gaining in popularity, because conservative treatment is ineffective. However, a cost-effectiveness analysis has never been performed and is the main goal of the present study.


METHODS
21 consecutive morbidly obese patients were tested before and after vertical banded gastroplasty (VBG). Quality of life was assessed with the Nottingham Health Profile and a visual analogue scale. A prevalence-based cost-of-illness analysis of morbid obesity was performed and the cost-effectiveness of VBG assessed.


RESULTS
VBG resulted in a significant weight loss and an improved quality of life. The improved quality of life combined with 3.6 life-years gained after VBG resulted in 12 quality adjusted life-years (QALY) gained in a lifelong scenario. Lifelong costs of illness of morbidly obese persons ranged from $8,304 to $9,367. Total direct costs of VBG were $5,865. The percentage of patients performing paid labor increased from 19% before VBG to 48% after VBG, resulting in an average productivity gain of $2,765 per year. In summary, the cost-effectiveness analysis revealed that surgical treatment of morbid obesity by means of VBG saves $4,004 to $3,928 per QALY (overall dominance).


CONCLUSIONS
Because treatment of morbid obesity with VBG results in QALYs gained and less costs, there is no doubt that this procedure should be introduced or continued from a societal point of view.
van Gemert
W G
WG
Department of Surgery, University Hospital Maastricht, The Netherlands. wg.gemert@wxs.nl
Adang
E M
EM
Kop
M
M
Vos
G
G
Greve
J W
JW
Soeters
P B
PB
D000328:Adult; D000704:Analysis of Variance; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D015391:Gastroplasty / Q000191:economics* / Q000379:methods; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009767:Obesity, Morbid / Q000191:economics* / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D015431:Weight Loss