title: Actual medical and pharmacy costs for bariatric surgery:  6-year follow-up.
abstract: OBJECTIVE
  To determine the change in total medical expenditures, total pharmacy expenditures, and subcategories of medical and pharmacy expenditures in obese individuals following weight loss surgery (WLS), and to compare these costs with expenditures in obese individuals not receiving WLS.
  
  
  METHODS
  Louisiana Office of Group Benefits (OGB), the state-managed health insurer, invited members to be evaluated for insurance-covered WLS. Of 951 obese members who provided written consent to begin the WLS screening process, 40 were selected for surgery. Medical and pharmaceutical claims cost data of the 911 patients who did not have surgery and the 39 individuals who completed surgery were compared over a 2-year presurgical and 6-year postsurgical period.
  
  
  RESULTS
  Total nonpharmacy medical costs were lower for WLS patients compared with non-WLS patients beginning 4 years postsurgery and lasting through 6 years postsurgery. No differences were found between WLS and non-WLS patients in expenditures for most medical subcategories examined, including emergency department, physical and occupational therapy, office visits, and laboratory/pathology; whereas sleep facility and all remaining medical expenditures not represented by a subcategory were lower for WLS patients during some postsurgery years. Total pharmacy costs were lower for WLS participants at 2 and 3 years postsurgery, but these lower costs were not maintained; however, costs remained lower for antidiabetic agents, antihypertensive agents, and dyslipidemic agents through all 6 postsurgery years under study.
  
  
  CONCLUSIONS
  The cost of WLS may begin to be recouped within the first 4 years postsurgery with continued effects 6 years postsurgery.
authors.affiliation: Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd., Baton Rouge, LA 70808, USA. Valerie.Myers@pbrc.edu
authors.forename: Valerie H
authors.initials: VH
authors.lastname: Myers
authors.forename: Megan A
authors.initials: MA
authors.lastname: McVay
authors.forename: Claire E
authors.initials: CE
authors.lastname: Adams
authors.forename: Brooke L
authors.initials: BL
authors.lastname: Barbera
authors.forename: Meghan M
authors.initials: MM
authors.lastname: Brashear
authors.forename: William D
authors.initials: WD
authors.lastname: Johnson
authors.forename: Patricia Smith
authors.initials: PS
authors.lastname: Boyd
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Brantley
mesh_terms: D050110:Bariatric Surgery / Q000191:economics*; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics / Q000601:surgery