Abstract
Background
Employers and insurers have become increasingly concerned about the cost implications
of providing coverage for bariatric procedures. We sought to quantify the costs and
potential cost savings resulting from coverage for laparoscopic adjustable gastric
banding (LAGB) using a claims analysis.
Methods
U.S. healthcare claims data of >7000 LAGB patients and a propensity score-matched
control group were used to quantify the costs and potential cost savings resulting
from LAGB for the overall surgery-eligible population and for the subset of the surgery-eligible
population with diabetes mellitus. The matched control group consisted of those with
a morbid obesity diagnosis code and/or a body mass index >35 kg/m2 as reported in the Health Risk Assessment data.
Results
Including the related medical payments in the 90 days before and after the procedure,
the mean cost of LAGB was approximately $20,000. After placement, a modest reduction
occurred in the health expenditures relative to the preoperative payments. In the
postoperative period, these decreases were maintained for the LAGB sample. In contrast,
the payments for the comparison sample continued to increase. As a result, the net
cost of coverage for LAGB was reduced to 0 by approximately 4 years after band placement.
For those with diabetes, the net costs resulting from LAGB were reduced to 0 in just
>2 years.
Conclusion
These results suggest that the LAGB procedure pays for itself within a relatively
short period, especially for those with diabetes.
Keywords
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References
- Impact of overweight on the risk of developing common chronic diseases during a 10-year period.Arch Intern Med. 2001; 161: 1581-1586
- Individual and aggregate years-of-life-lost associated with overweight and obesity.Obesity. 2010; 18: 333-339
- Clinical application of laparoscopic bariatric surgery: an evidence-based review.Surg Endosc. 2009; 23: 930-949
- The clinical effectiveness and cost effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation.Health Technol Assess. 2009; 13: 1-6
- Metabolic and bariatric surgery fact sheet.(Accessed: October 6, 2009)
- Longitudinal Assessment of Bariatric Surgery (LABS) Consortium.N Engl J Med. 2009; 361: 445-454
- Clinical and cost effectiveness of surgery for morbid obesity: a systematic review and economic evaluation.Int J Obes Relat Metab Disord. 2003; 10: 1167-1177
- Bariatric surgery: a systematic review and meta-analysis.JAMA. 2004; 292: 1724-1737
- Cost-effectiveness of gastric bypass for severe obesity.Am J Med. 2002; 113: 491-498
- Cost-effectiveness analysis of laparoscopic gastric bypass, adjustable gastric banding, and nonoperative weight loss interventions.Surg Obes Relat Dis. 2008; 4: 26-32
- Cost-effectiveness of roux-en-Y gastric bypass in type 2 diabetes patients.Am J Manag Care. 2009; 15: 609-615
- The fattening of America.Wiley, Hoboken, NJ2008
- Annual medical spending attributable to obesity: payer- and service-specific estimates.Health Aff. 2009; 28: w822-w831
- The impact of weight reduction surgery on health-care costs in morbidly obese patients.Obes Surg. 2004; 14: 939-947
- A cost-benefit simulation model of coverage for bariatric surgery among full-time employees.Am J Manag Care. 2005; 11: 641-646
- A study on the economic impact of bariatric surgery.Am J Manag Care. 2008; 14: 589-596
- Cost-efficacy of surgically induced weight loss for the management of type 2 diabetes.Diabetes Care. 2009; 32: 580-584
- Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial.JAMA. 2008; 299: 316-323
- MarketScan® Database 2003–2008.(Accessed December 12, 2010)
- Hospital costs associated with bariatric procedures in the United States.Am J Surg. 2005; 190: 816-820
- Use and costs of bariatric surgery and prescription weight-loss medications.Health Aff. 2005; 24: 1039-1046
- Some practical guidance for the implementation of propensity score matching.J Econ Surv. 2008; 22: 31-72
- The central role of the propensity score in observational studies for causal effects.Biometrika. 1983; 70: 41-55
- Too much ado about two-part models and transformation?.J Health Econ. 2004; 23: 525-542
- Stata statistical software, Release 10.1 [computer program].Statacorp LP, College Station, TX2008
- Cardiovascular risk after bariatric surgery for obesity.Am J Cardiol. 2008; 102: 930-937
- Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients.Ann Surg. 2004; 240: 416-423
- Five-year outcomes of patients with type 2 diabetes who underwent laparoscopic adjustable gastric banding.Surg Obes Relat Dis. 2010; 6: 373-376
- Obesity and overweight: health consequences.(Accessed September 10, 2010)
- Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss.Circulation. 2006; 113: 898-918
Article info
Publication history
Published online: November 01, 2010
Accepted:
October 6,
2010
Received:
June 15,
2010
Identification
Copyright
© 2011 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
