title: Prescription drug cost reduction in Native Hawaiians after laparoscopic Roux-en-y gastric bypass.
abstract: OBJECTIVE
  Native Hawaiians (NH) represent a unique population where socioeconomic factors have contributed to higher incidence rates of obesity and related comorbidities than in the general population resulting in substantial prescription medication costs. Studies demonstrate that laparoscopic Roux-en-y gastric bypass (LRYGB) surgery results in significant weight loss, improvement of comorbidities, and decreased costs for prescription medications in Caucasians. This study aimed to analyze the effects of LRYGB surgery on Native Hawaiians and their prescription drug costs.
  
  
  METHODS
  Demographics, baseline body mass index (BMI), comorbidities, preoperative, and postoperative data were analyzed for NH patients who underwent LRYGB between January 2004 and April 2009. Medication costs were determined using the online pharmacy <http://www.drugstore.com>. Generic drugs were selected when appropriate, while vitamins and nutritional supplements were not included in this study.
  
  
  RESULTS
  Fifty (14 Men, 36 women) NH patients had sufficient data and follow-up for analysis. Average preoperative BMI was 49 kg/m(2), while at one year follow-up it decreased to 33 kg/m(2) (P<.001). This correlates to an average of 61% excess body weight lost (P<.001). The average number of prescription medications decreased from 3.5/patient preoperatively to 1.1/patient at one year (P<.001), equating to a monthly cost savings of US $195.8/patient (P<.001).
  
  
  CONCLUSIONS
  LRYGB provided substantial weight loss for morbidly obese NH patients, resulting in significantly less prescription medication use and substantial cost savings. Thus, bariatric surgery for weight management has the potential to improve the overall well-being and lower the financial burden of medical care in socioeconomically disadvantaged communities such as the NH.
authors: ARTEMIS (Association of Research, Training and Education in Minimally Invasive Surgery) Research Group, Department of Surgery, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI 96813, USA.
authors: Edward C F
authors: EC
authors: Lam
authors: Daniel
authors: D
authors: Murariu
authors: Edwin
authors: E
authors: Takahashi
authors: Chan W
authors: CW
authors: Park
authors: Racquel S
authors: RS
authors: Bueno
authors: Cedric S F
authors: CS
authors: Lorenzo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D017046:Cost Savings / Q000706:statistics & numerical data*; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D009767:Obesity, Morbid / Q000191:economics / Q000208:ethnology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Native Hawaiians; bariatric surgery; laparoscopic rouex-en-y gastric bypass; prescription costs