西班牙肥胖症患者的减肥手术与保守治疗：成本效益分析

Bariatric surgery versus conservative management for morbidly obese patients in Spain: a cost-effectiveness analysis.

作者信息

Sanchez-Santos Raquel, Padin Esther Mariño, Adam Daniel, Borisenko Oleg, Fernandez Sergio Estevez, Dacosta Ester Carrera, Fernández Sonia González, Vazquez Juan Turnes, de Adana Juan Carlos Ruiz, de la Cruz Vigo Felipe

机构信息

a General and Digestive Surgery Department , Complejo Hospitalario de Pontevedra, Instituto de Investigación Galicia Sur , Pontevedra , Spain.

b General and Digestive Surgery Department , Complejo Hospitalario de Pontevedra , Pontevedra , Spain.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2018 Jun;18(3):305-314. doi: 10.1080/14737167.2018.1407649. Epub 2017 Nov 30.

DOI:10.1080/14737167.2018.1407649

PMID:29188745

Abstract

BACKGROUND

We assessed the cost-effectiveness of bariatric surgery (BS) versus conservative management (CM) for treating morbid obesity in Spain.

METHODS

We developed a probabilistic Markov model to estimate health outcomes, quality-adjusted life years (QALY), life years gained (LYG), and costs over lifetime and 10-year horizons. Combined common BS procedures were compared with CM. Clinical and utility inputs were obtained from the literature and resource use and costs from local sources (€2017).

RESULTS

Over the 10-year horizon, BS led to a cost increment of €9,386 and 1.6 additional QALY (€5,966/QALY). Leading to 0.6 LYG and 4.4 QALY gains and €300/patient average cost savings over lifetime, BS could potentially significantly reduce diabetes and cardiovascular disease risk over the considered horizons. Despite short-term cost reductions, surgery delay may lead to significant clinical benefits loss.

CONCLUSIONS

Compared to CM, BS is a more effective and less costly alternative for treating morbid obesity in Spain.

摘要

背景

我们评估了在西班牙，减肥手术（BS）与保守治疗（CM）相比治疗病态肥胖的成本效益。

方法

我们建立了一个概率马尔可夫模型，以估计健康结果、质量调整生命年（QALY）、获得的生命年（LYG）以及终生和10年期间的成本。将联合常见的减肥手术程序与保守治疗进行比较。临床和效用输入来自文献，资源使用和成本来自当地来源（2017欧元）。

结果

在10年期间，减肥手术导致成本增加9386欧元，额外增加1.6个QALY（5966欧元/QALY）。减肥手术在终生可带来0.6个LYG和4.4个QALY的增加，平均每位患者节省成本300欧元，在考虑的时间段内可能显著降低糖尿病和心血管疾病风险。尽管短期内成本降低，但手术延迟可能导致显著的临床效益损失。