New Study Finds Healthcare Costs Drop Dramatically After Bariatric Surgery
Patients with Diabetes See Nearly Double the Cost Savings
4-Nov-2015 1:00 PM EST
A new study based on national insurance claims in the United States found that patients with obesity who had gastric bypass surgery cut their healthcare costs by nearly 40 percent after four years, and by 80 percent, if they also had type 2 diabetes before surgery.
The findings were presented here at ObesityWeek 2015, the largest international event focused on the basic science, clinical application and prevention and treatment of obesity. The weeklong conference is hosted by the
American Society for Metabolic and Bariatric Surgery (ASMBS) and The Obesity Society (TOS).
Healthcare costs among patients who had laparoscopic gastric bypass were $7,592 less than they were for an equal number of matched patients with severe obesity who did not have surgery – a savings of nearly 40 percent. Patients with diabetes saw a 78 percent drop in costs, which translates to savings of $22,609, when compared to their non-surgical counterparts after four years. About 70 percent of patients experienced remission of their diabetes after surgery.
“The main reduction in costs were related to fewer hospital admissions and clinic visits, and a reduction in the use of prescription drugs for diabetes, hypertension, and heart disease,” said study-co-author John M. Morton, MD, MPH, Chief, Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine and president of the ASMBS. “Costs were higher across the board for patients who did not have bariatric surgery showing there is an even higher cost to not treating obesity, in dollars as this study shows and in longevity and quality of life, as many other studies have shown.”
Dr. Morton and researchers analyzed data from the Truven Health Analytics Commercial Claims (MarketScan) database, which consists of insurance claims from at least 15 million people. A total of 823 laparoscopic gastric bypass patients were identified and propensity matched to 786 non-surgical patients based on age, sex and geographic region, in addition to the presence of diabetes, hypertension, hyperlipidemia and severe obesity one year before surgery. All surgeries took place in 2008 and all patients were continuously covered by insurance for the study period, which covered 2004 to 2012.
In the study, the average cost of gastric bypass surgery was $25,238. In each of the four years after surgery healthcare costs dropped by 12 percent, 28 percent, 37 percent and 35 percent, respectively. Costs dropped even more dramatically for those who had diabetes. In the first year, costs were 23 percent lower and continued to drop over the next three years, 49 percent, 61 percent and 69 percent, respectively. Researchers say the trend toward lower costs is expected to continue for surgical patients beyond the four years of the study period, while costs for non-surgical patients are expected to increase.
“The findings show treating obesity has important health benefits that translate into real cost savings,” said Robin Blackstone, MD, Chief, Section of Bariatric and Metabolic Surgery at Banner - University Medical Center, who was not involved in the study. “Bariatric surgery saves lives and money and is one of the best investments patients and their insurers can make.”
In addition to Dr. Morton, study authors of the abstract entitled, “Bariatric Surgery Reduces National Healthcare Utilization in the Long-Term,” include Stacy Brethauer, MD, Cleveland Clinic, OH; Jaime Ponce, MD, Hamilton Medical Center, TN, Raul Rosenthal, MD, Cleveland Clinic Florida; and Ninh Nguyen, MD, University of California, Irvine.
About Obesity and Metabolic and Bariatric Surgery
According to the Centers of Disease Control and Prevention (CDC), more than 78 million adults were obese in 2011–2012.i The ASMBS estimates about 24 million people have severe or morbid obesity. Individuals with a BMI greater than 30 have a 50 to 100 percent increased risk of premature death compared to healthy weight individuals as well as an increased risk of developing more than 40 obesity-related diseases and conditions including type 2 diabetes, heart disease and cancer.ii,iii
Metabolic/bariatric surgery has been shown to be the most effective and long lasting treatment for morbid obesity and many related conditions and results in significant weight loss. The Agency for Healthcare Research and Quality (AHRQ) reported significant improvements in the safety of metabolic/bariatric surgery due in large part to improved laparoscopic techniques.iv The risk of death is about 0.1 percentv and the overall likelihood of major complications is about 4 percent.vi
The ASMBS is the largest organization for bariatric surgeons in the nation. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in obesity, while maintaining a steady exchange of experiences and ideas that may lead to improved outcomes for morbidly obese patients. For more information, visit www.asmbs.org.
*BARIATRIC SURGERY REDUCES NATIONAL HEALTHCARE UTILIZATION IN THE LONG-TERM –
John Morton, MD; Stacy Brethauer, MD; Jaime Ponce, MD; Raul Rosenthal, MD; Ninh Nguyen, MD; Presented
November 4, 2015
iiOffice of the Surgeon General – U.S. Department of Health and Human Services. Overweight and obesity: health consequences. Accessed March 2012 from http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.html
iiiKaplan, L. M. (2003). Body weight regulation and obesity. Journal of Gastrointestinal Surgery. 7(4) pp. 443-51. Doi:10.1016/S1091-255X(03)00047-7.
ivPoirier, P., Cornier, M. A., Mazzone, T., et al. (2011). Bariatric surgery and cardiovascular risk factors. Circulation: Journal of the American Heart Association. 123 pp. 1-19. Accessed March 2012 from http://circ.ahajournals.org/content/123/15/1683.full.pdf
vAgency for Healthcare Research and Quality (AHRQ). Statistical Brief #23. Bariatric Surgery Utilization and Outcomes in 1998 and 2004. Jan 2007
viFlum, D. R. et al. (2009). Perioperative safety in the longitudinal assessment of bariatric surgery. New England Journal of Medicine. 361 pp.445-454. Accessed June 2012 from http://content.nejm.org/cgi/content/full/361/5/445