title: Cost-utility of bariatric surgery for morbid obesity in Finland.
abstract: BACKGROUND
  The aim of this study was to evaluate the cost-utility of bariatric surgery (gastric bypass, sleeve gastrectomy and gastric banding) compared with ordinary treatment in the Finnish healthcare system.
  
  
  METHODS
  Analysis was done from a healthcare provider's perspective using a combination of a decision tree and a Markov model, with a time horizon of 10 years. Health-related quality of life was estimated from a representative population survey, and other parameter values were based on registers, systematic reviews, controlled studies and expert opinion.
  
  
  RESULTS
  In the base-case analysis, bariatric surgery was both more effective and less costly than the ordinary treatment. The mean costs were €33,870 and €50,495, and the mean number of quality-adjusted life-years 7·63 and 7·05, for bariatric surgery and ordinary treatment respectively. Uncertainty around the parameter values was tested comprehensively in sensitivity analyses, and the results were robust.
  
  
  CONCLUSIONS
  Surgery for morbid obesity increases health-related quality of life, and reduces the need for further treatments and total healthcare costs. According to this analysis, non-operative care would be more costly for the Finnish healthcare system on average after 5 years following surgery.
authors: Finnish Office for Health Technology Assessment, National Institute for Health and Welfare, Helsinki, Finland. suvi.maklin@thl.fi
authors: S
authors: S
authors: Mäklin
authors: A
authors: A
authors: Malmivaara
authors: M
authors: M
authors: Linna
authors: M
authors: M
authors: Victorzon
authors: V
authors: V
authors: Koivukangas
authors: H
authors: H
authors: Sintonen
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000191:economics* / Q000379:methods; D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000191:economics* / Q000601:surgery; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D015431:Weight Loss