Gesquiere Ina, Aron-Wisnewsky Judith, Foulon Veerle, Haggege Steeve, Van der Schueren Bart, Augustijns Patrick, Bouillot Jean-Luc, Clement Karine, Basdevant Arnaud, Oppert Jean-Michel, Buyse Marion
Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, O&N II, Herestraat 49, Box 521, 3000, Leuven, Belgium,
Obes Surg. 2014 Nov;24(11):1896-903. doi: 10.1007/s11695-014-1325-8.
This study aims to determine the influence of Roux-en-Y gastric bypass (RYGB) on medication-related costs.
The study analyzed the types, dosages, and costs of drugs and medical devices prescribed before and after surgery (1, 3, 6, and 12 months and yearly thereafter) in patients who underwent RYGB between June 2004 and May 2010 and had an outpatient visit between December 2009 and May 2010 at Pitié-Salpêtrière University Hospital, Paris, France.
The cohort included 143 patients (78 % female; mean age, 42.9 years; mean BMI, 48.6 kg/m(2)). Total prescription costs were significantly lower (-32 %, p < 0.001) 1 year after RYGB compared with preoperative costs. However, the cost for medications to prevent RYGB side effects (in particular nutritional deficiencies) displayed a 36-fold increase in the first month postsurgery, but then decreased progressively over time. Importantly, the cost related to the treatment of the two most frequent obesity-related diseases significantly decreased 1 year after surgery. Indeed, prescription costs for treatment of type 2 diabetes (T2D) and obstructive sleep apnea (OSA) (namely CPAP therapy considered as the gold standard treatment) were reduced 1 year after surgery by 85 and by 63 % (both p < 0.001), respectively. We also observed a trend toward a decrease in the prescription costs of other obesity-related diseases, although it did not reach significance in our cohort.
Considering medication to treat both obesity-related diseases and prevention of secondary effects of bariatric surgery, we observed that overall postoperative medication costs were significantly reduced one year after surgery, especially for T2D and OSA.
本研究旨在确定Roux-en-Y胃旁路术（RYGB）对药物相关费用的影响。
本研究分析了2004年6月至2010年5月期间接受RYGB手术，并于2009年12月至2010年5月在法国巴黎皮提耶-萨尔佩特里尔大学医院门诊就诊的患者手术前后（术后1、3、6和12个月以及此后每年）所开药物和医疗器械的类型、剂量及费用。
该队列包括143例患者（78%为女性；平均年龄42.9岁；平均BMI为48.6kg/m²）。与术前费用相比，RYGB术后1年总处方费用显著降低（-32%，p<0.001）。然而，预防RYGB副作用（尤其是营养缺乏）的药物费用在术后第一个月增加了36倍，但随后随时间逐渐下降。重要的是，与两种最常见的肥胖相关疾病治疗相关的费用在术后1年显著降低。事实上，术后1年，2型糖尿病（T2D）和阻塞性睡眠呼吸暂停（OSA）（即被视为金标准治疗的持续气道正压通气治疗）的治疗处方费用分别降低了85%和63%（均p<0.001）。我们还观察到其他肥胖相关疾病的处方费用有下降趋势，尽管在我们的队列中未达到显著水平。
考虑到治疗肥胖相关疾病的药物以及减肥手术继发效应的预防，我们观察到术后1年总体药物费用显著降低，尤其是T2D和OSA。
