Document Detail


Economic impact of the clinical benefits of bariatric surgery in diabetes patients with BMI ≥35 kg/m².
MedLine Citation:
PMID:  20829800     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The medical costs for a type 2 diabetes patient are two to four times greater than the costs for a patient without diabetes. Bariatric surgery is the most effective weight-loss therapy and has marked therapeutic effects on diabetes. We estimate the economic effect of the clinical benefits of bariatric surgery for diabetes patients with BMI ≥ 35 kg/m². Using an administrative claims database of privately insured patients covering 8.5 million lives 1999-2007, we identify obese patients with diabetes, aged 18-65 years, who were treated with bariatric surgery identified using Healthcare Common Procedure Coding System codes. These patients were matched with nonsurgery control patients on demographic factors, comorbidities, and health-care costs. The overall return on investment (RoI) associated with bariatric surgery was calculated using multivariate analysis. Surgery and control patients were compared postindex with respect to diagnostic claims for diabetes, diabetes medication claims, and adjusted diabetes medication and supply costs. Surgery costs were fully recovered after 26 months for laparoscopic surgery. At month 6, 28% of surgery patients had a diabetes diagnosis, compared to 74% of control patients (P < 0.001). Among preindex insulin users, insulin use dropped to 43% by month 3 for surgery patients, vs. 84% for controls (P < 0.001). By month 1, medication and supply costs were significantly lower for surgery patients (P < 0.001). The therapeutic benefits of bariatric surgery on diabetes translate into considerable economic benefits. These data suggest that surgical therapy is clinically more effective and ultimately less expensive than standard therapy for diabetes patients with BMI ≥ 35 kg/m².
Authors:
Samuel Klein; Arindam Ghosh; Pierre Y Cremieux; Sara Eapen; Tamara J McGavock
Publication Detail:
Type:  Journal Article     Date:  2010-09-09
Journal Detail:
Title:  Obesity (Silver Spring, Md.)     Volume:  19     ISSN:  1930-7381     ISO Abbreviation:  Obesity (Silver Spring)     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-24     Completed Date:  2011-10-04     Revised Date:  2012-02-03    
Medline Journal Info:
Nlm Unique ID:  101264860     Medline TA:  Obesity (Silver Spring)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  581-7     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Bariatric Surgery / economics*
Body Mass Index
Case-Control Studies
Diabetes Mellitus, Type 2 / complications,  drug therapy,  economics*,  surgery
Female
Health Care Costs*
Humans
Hypoglycemic Agents / economics,  therapeutic use
Insulin / economics,  therapeutic use
Middle Aged
Multivariate Analysis
Obesity / complications,  economics*,  surgery
Young Adult
Grant Support
ID/Acronym/Agency:
P30 DK056341-11/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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