Cost-effectiveness of gastric bypass for severe obesity.
OBJECTIVE
To estimate the cost-effectiveness of gastric bypass in the treatment of severe obesity.


METHODS
We performed a cost-effectiveness analysis of gastric bypass versus no treatment from the payer perspective. We discounted quality-adjusted life-years (QALYs), life-years, and cost during the patient's lifetime. Our target group comprised women and men aged 35 to 55 years with a body mass index between 40 and 50 kg/m(2), and who did not have cardiovascular disease and in whom conservative bariatric therapies had been unsuccessful.


RESULTS
The base case cost-effectiveness ratios ranged from 5000 dollars to 16,100 dollars per QALY for women and from 10,000 dollars to 35,600 dollars per QALY for men, depending on age and initial body mass index. In a few subgroups of older, less obese men, variation in parameters such as loss of excess weight, obesity-related quality of life, complication rates, and perioperative mortality affected the cost-effectiveness ratios. Parameter variation did not result in meaningful changes in the remaining patients.


CONCLUSIONS
Gastric bypass is a cost-effective alternative to no treatment, providing substantial lifetime benefits in patients who are severely obese.
Craig
Benjamin M
BM
Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin, USA. bmcraig@wisc.edu
Tseng
Daniel S
DS
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000191:economics*; D017048:Health Care Costs; D017722:Hospital Charges; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000191:economics* / Q000601:surgery*; D011183:Postoperative Complications / Q000191:economics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years