Craig Benjamin M, Tseng Daniel S
Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin, USA.
Am J Med. 2002 Oct 15;113(6):491-8. doi: 10.1016/s0002-9343(02)01266-4.
To estimate the cost-effectiveness of gastric bypass in the treatment of severe obesity.
We performed a cost-effectiveness analysis of gastric bypass versus no treatment from the payer perspective. We discounted quality-adjusted life-years (QALYs), life-years, and cost during the patient's lifetime. Our target group comprised women and men aged 35 to 55 years with a body mass index between 40 and 50 kg/m(2), and who did not have cardiovascular disease and in whom conservative bariatric therapies had been unsuccessful.
The base case cost-effectiveness ratios ranged from 5000 dollars to 16,100 dollars per QALY for women and from 10,000 dollars to 35,600 dollars per QALY for men, depending on age and initial body mass index. In a few subgroups of older, less obese men, variation in parameters such as loss of excess weight, obesity-related quality of life, complication rates, and perioperative mortality affected the cost-effectiveness ratios. Parameter variation did not result in meaningful changes in the remaining patients.
Gastric bypass is a cost-effective alternative to no treatment, providing substantial lifetime benefits in patients who are severely obese.
评估胃旁路手术治疗重度肥胖的成本效益。
我们从支付方的角度对胃旁路手术与不治疗进行了成本效益分析。我们对患者一生中的质量调整生命年（QALY）、生命年和成本进行了贴现。我们的目标群体包括年龄在35至55岁之间、体重指数在40至50 kg/m²之间、没有心血管疾病且保守减肥治疗未成功的男性和女性。
根据年龄和初始体重指数，基础病例的成本效益比女性为每QALY 5000美元至16,100美元，男性为每QALY 10,000美元至35,600美元。在一些年龄较大、肥胖程度较低的男性亚组中，如超重减轻、肥胖相关生活质量、并发症发生率和围手术期死亡率等参数的变化影响了成本效益比。参数变化在其余患者中未导致有意义的变化。
对于重度肥胖患者，胃旁路手术是一种比不治疗更具成本效益的选择，可在患者一生中带来显著益处。
