Background:
The objective of the study was to evaluate the cost–utility of bariatric surgery in England.
Methods:
A state-transition Markov model was developed to compare the costs and outcomes of two
treatment approaches for patients with morbid obesity: bariatric surgery, including gastric bypass, sleeve
gastrectomy and adjustable gastric banding; and non-surgical usual care. Parameters of the effectiveness
of surgery and complications were informed by data from the UK National Bariatric Surgery Registry, the
Scandinavian Obesity Registry and the Swedish Obese Subjects study. Costs and utilities were informed
by UK sources.
Results:
Bariatric surgery was associated with reduced mean costs to the health service by €2742 (£1944),
and gain of 0
⋅
8 life-years and 4
⋅
0 quality-adjusted life years (QALYs) over a lifetime compared with usual
care. Bariatric surgery also had the potential to reduce the lifetime risks of obesity-related cardiovascular
diseases and diabetes. Delaying surgery for up to 3 years resulted in a reduction of 0
⋅
7 QALYs and a minor
decrease of €2058 (£1459) in associated healthcare costs.
Conclusion:
Currently used surgical methods were found to be cost saving over the lifetime of individuals
treated in England. Delays in surgical provision can lead to a loss of clinical benefits.