Bariatric surgery: shedding the monetary weight of prescription costs in the managed care arena.
BACKGROUND
Prescription costs for treatment of comorbidities associated with morbid obesity is a considerable annual health-care expenditure. This study addressed the effect of Roux-en-Y gastric bypass (RYGBP) on diabetic and anti-hypertensive pharmaceutical utilization and cost savings at our institution.


METHODS
Retrospective data from the electronic database of 51 consecutive patients, who underwent RYGBP from March 2001 to May 2002 were studied. Patients had BMI >40 associated with obesity-related diabetes and hypertension. Prescription medications utilized by this cohort were reviewed preoperatively and at 3- and 9-month intervals postoperatively. Significance was analyzed by paired t-test.


RESULTS
Prevalence of diabetes and hypertension was 55.7% (29/53) and 44.3% (24/53) respectively, and 34% (18/53) patients had both co-morbidities. Preoperatively, patients were on an average of 2.44 +/- 1.86 medications at a cost of 187.24 USD +/- 237.41 USD per month. Postoperatively, the mean number of medications was reduced to 0.56 +/- 0.81 agents (P<0.001) at a monthly cost of 42.53 USD +/- 116.60 (P<0.001).


CONCLUSIONS
RYGBP can decrease the prescription medication requirements, resulting in significant cost-savings in the treatment of obesity-related hypertension and diabetes. This study found a 77.3% reduction in total cost of diabetic and anti-hypertensive medications.
Department of Gastroenterology and Nutrition, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA 17822-2111, USA. cpotteiger@geisinger.edu
Chad E
CE
Potteiger
Prakash R
PR
Paragi
Nicholas A
NA
Inverso
Christopher
C
Still
Mary Jane
MJ
Reed
William
W
Strodel
Marc
M
Rogers
Anthony
A
Petrick
D000328:Adult; D000959:Antihypertensive Agents / Q000191:economics*; D017046:Cost Savings; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000191:economics*; D016527:Drug Costs; D005260:Female; D015390:Gastric Bypass / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D010535:Laparoscopy / Q000191:economics; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009765:Obesity; D009767:Obesity, Morbid / Q000191:economics / Q000453:epidemiology* / Q000601:surgery; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies
D000959:Antihypertensive Agents