title: Medication cost is significantly reduced after Roux-en-Y gastric bypass in obese patients.
abstract: BACKGROUND
  This study aims to determine the influence of Roux-en-Y gastric bypass (RYGB) on medication-related costs.
  
  
  METHODS
  The study analyzed the types, dosages, and costs of drugs and medical devices prescribed before and after surgery (1, 3, 6, and 12 months and yearly thereafter) in patients who underwent RYGB between June 2004 and May 2010 and had an outpatient visit between December 2009 and May 2010 at Pitié-Salpêtrière University Hospital, Paris, France.
  
  
  RESULTS
  The cohort included 143 patients (78 % female; mean age, 42.9 years; mean BMI, 48.6 kg/m(2)). Total prescription costs were significantly lower (-32 %, p < 0.001) 1 year after RYGB compared with preoperative costs. However, the cost for medications to prevent RYGB side effects (in particular nutritional deficiencies) displayed a 36-fold increase in the first month postsurgery, but then decreased progressively over time. Importantly, the cost related to the treatment of the two most frequent obesity-related diseases significantly decreased 1 year after surgery. Indeed, prescription costs for treatment of type 2 diabetes (T2D) and obstructive sleep apnea (OSA) (namely CPAP therapy considered as the gold standard treatment) were reduced 1 year after surgery by 85 and by 63 % (both p < 0.001), respectively. We also observed a trend toward a decrease in the prescription costs of other obesity-related diseases, although it did not reach significance in our cohort.
  
  
  CONCLUSIONS
  Considering medication to treat both obesity-related diseases and prevention of secondary effects of bariatric surgery, we observed that overall postoperative medication costs were significantly reduced one year after surgery, especially for T2D and OSA.
authors.affiliation: Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, O&N II, Herestraat 49, Box 521, 3000, Leuven, Belgium, ina.gesquiere@pharm.kuleuven.be.
authors.forename: Ina
authors.initials: I
authors.lastname: Gesquiere
authors.forename: Judith
authors.initials: J
authors.lastname: Aron-Wisnewsky
authors.forename: Veerle
authors.initials: V
authors.lastname: Foulon
authors.forename: Steeve
authors.initials: S
authors.lastname: Haggege
authors.forename: Bart
authors.initials: B
authors.lastname: Van der Schueren
authors.forename: Patrick
authors.initials: P
authors.lastname: Augustijns
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bouillot
authors.forename: Karine
authors.initials: K
authors.lastname: Clement
authors.forename: Arnaud
authors.initials: A
authors.lastname: Basdevant
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.forename: Marion
authors.initials: M
authors.lastname: Buyse
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000191:economics / Q000379:methods*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000191:economics / Q000601:surgery*; D010297:Paris; D012189:Retrospective Studies; D016896:Treatment Outcome