Health Economics and Market Access, Synergus AB, Stockholm, Sweden.
Department of Surgery and Cancer, Imperial College London, London, UK.
Br J Surg. 2018 Sep;105(10):1328-1337. doi: 10.1002/bjs.10857. Epub 2018 Apr 17.
The objective of the study was to evaluate the cost-utility of bariatric surgery in England.
A state-transition Markov model was developed to compare the costs and outcomes of two treatment approaches for patients with morbid obesity: bariatric surgery, including gastric bypass, sleeve gastrectomy and adjustable gastric banding; and non-surgical usual care. Parameters of the effectiveness of surgery and complications were informed by data from the UK National Bariatric Surgery Registry, the Scandinavian Obesity Registry and the Swedish Obese Subjects study. Costs and utilities were informed by UK sources.
Bariatric surgery was associated with reduced mean costs to the health service by €2742 (£1944), and gain of 0·8 life-years and 4·0 quality-adjusted life-years (QALYs) over a lifetime compared with usual care. Bariatric surgery also had the potential to reduce the lifetime risks of obesity-related cardiovascular diseases and diabetes. Delaying surgery for up to 3 years resulted in a reduction of 0·7 QALYs and a minor decrease of €2058 (£1459) in associated healthcare costs.
Currently used surgical methods were found to be cost saving over the lifetime of individuals treated in England.
本研究旨在评估英国减重手术的成本效用。
采用状态转移马尔可夫模型比较了两种治疗病态肥胖患者的方法的成本和结果：减重手术，包括胃旁路手术、袖状胃切除术和可调胃束带术；以及非手术常规护理。手术效果和并发症的参数信息来源于英国国家减重手术登记处、斯堪的纳维亚肥胖症登记处和瑞典肥胖受试者研究的数据。成本和效用信息来源于英国来源。
与常规护理相比，减重手术使卫生服务的平均成本降低了 2742 欧元（1944 英镑），并获得了 0.8 个生命年和 4.0 个质量调整生命年（QALYs）。减重手术还有可能降低与肥胖相关的心血管疾病和糖尿病的终生风险。将手术推迟至多 3 年，将减少 0.7 个 QALYs，并使相关医疗保健成本降低 2058 欧元（1459 英镑）。
在英国接受治疗的个体的一生中，目前使用的手术方法被发现具有成本效益。
