title: Bariatric surgery for the treatment of severely obese patients in South Korea--is it cost effective?
abstract: BACKGROUND
  In South Korea, the number of severely obese patients has increased. An economic study comparing bariatric surgery with nonsurgical interventions has not been published for Asia.
  
  
  OBJECTIVE
  This study was conducted to evaluate the cost effectiveness of bariatric surgery as compared to nonsurgical interventions for severe obese Korean people.
  
  
  METHODS
  We used the Markov model to compare the lifetime expected costs and quality-adjusted life years (QALYs) between bariatric surgery and nonsurgical interventions from Korean Healthcare system perspectives. Our target cohort consisted of severe obese people defined as having a body mass index of 30-<40 kg/m(2) in South Korea. The starting age of the cohort was 30 years old, and the cycle length was 1 year. Nonsurgical interventions included a physician visit, exercise, diet, and pharmacotherapy. A discount of 5 % was applied in cost and QALY. The incremental cost-effectiveness ratio (ICER) of bariatric surgery compared to nonsurgery interventions was calculated.
  
  
  RESULTS
  The cost-utility analysis study indicated that bariatric surgery had US$1,522 incremental costs and 0.86 incremental QALYs as compared to nonsurgical interventions. Through the base case analysis, ICER was US$1,771/QALY. The sensitivity analyses were performed using a variety of assumptions, and the robustness of the study results was also demonstrated.
  
  
  CONCLUSIONS
  The study indicated that bariatric surgery was a cost-effective alternative to nonsurgical interventions over a lifetime, providing substantial lifetime benefits for severely obese Korean people.
authors: National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea.
authors: Hyun Jin
authors: HJ
authors: Song
authors: Jin Won
authors: JW
authors: Kwon
authors: Yong Jin
authors: YJ
authors: Kim
authors: Sung-Hee
authors: SH
authors: Oh
authors: Yoonseok
authors: Y
authors: Heo
authors: Sang-Moon
authors: SM
authors: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050110:Bariatric Surgery / Q000191:economics*; D015992:Body Mass Index; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D003663:Decision Trees; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009749:Nutrition Surveys; D009767:Obesity, Morbid / Q000191:economics* / Q000453:epidemiology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D056910:Republic of Korea / Q000453:epidemiology; D016896:Treatment Outcome
references: Soc Sci Med. 2008 Dec;67(11):1717-26
references: 18945533
references: Am J Med. 2002 Oct 15;113(6):491-8
references: 12427499
references: Br J Rheumatol. 1997 May;36(5):551-9
references: 9189057
references: Diabetes Res Clin Pract. 1997 May;36(2):121-5
references: 9229196
references: Value Health. 2009 Nov-Dec;12(8):1187-93
references: 19659703
references: Obesity (Silver Spring). 2007 Feb;15(2):277-82
references: 17299099
references: Pharmacoeconomics. 2002;20(6):393-404
references: 12052098
references: Br J Surg. 2011 Oct;98(10):1422-9
references: 21887777
references: Surg Obes Relat Dis. 2008 Jan-Feb;4(1):26-32
references: 18069075
references: Value Health. 2008 May-Jun;11(3):424-34
references: 18179675
references: JAMA. 2012 Jan 4;307(1):56-65
references: 22215166
references: Ann Intern Med. 1991 Dec 15;115(12):956-61
references: 1952493
references: Obes Surg. 2012 Mar;22(3):502-6
references: 22033767
references: Health Policy. 1990 Dec;16(3):199-208
references: 10109801
references: Obes Surg. 2005 Jun-Jul;15(6):751-7
references: 15978141
references: Med Decis Making. 2006 Jul-Aug;26(4):410-20
references: 16855129
references: Health Technol Assess. 2009 Sep;13(41):1-190, 215-357, iii-iv
references: 19726018
references: J Korean Med Sci. 2011 Dec;26(12):1533-40
references: 22147988
references: Obes Surg. 2006 Nov;16(11):1488-503
references: 17132416
references: Int J Clin Pract. 2010 May;64(6):775-83
references: 20353431