School of Pharmacy, Memorial University of Newfoundland, St. John's, Canada.
PLoS One. 2021 Jul 28;16(7):e0254063. doi: 10.1371/journal.pone.0254063. eCollection 2021.
Procedure-less intragastric balloon (PIGB) eliminates costs and risks of endoscopic placement/removal and involves lower risk of serious complications compared with bariatric surgery, albeit with lower weight loss. Given the vast unmet need for obesity treatment, an important question is whether PIGB treatment is cost-effective-either stand-alone or as a bridge to bariatric surgery.
We developed a microsimulation model to compare the costs and effectiveness of six treatment strategies: PIGB, gastric bypass or sleeve gastrectomy as stand-alone treatments, PIGB as a bridge to gastric bypass or sleeve gastrectomy, and no treatment.
PIGB as a bridge to bariatric surgery is less costly and more effective than bariatric surgery alone as it helps to achieve a lower post-operative BMI. Of the six strategies, PIGB as a bridge to sleeve gastrectomy is the most cost-effective with an ICER of $3,781 per QALY gained. While PIGB alone is not cost-effective compared with bariatric surgery, it is cost-effective compared with no treatment with an ICER of $21,711 per QALY.
PIGB can yield cost savings and improve health outcomes if used as a bridge to bariatric surgery and is cost-effective as a stand-alone treatment for patients lacking access or unwilling to undergo surgery.
无程序胃内球囊（PIGB）消除了内镜放置/取出的成本和风险，与减重手术相比，严重并发症的风险较低，尽管减重效果较低。鉴于肥胖治疗的巨大未满足需求，一个重要的问题是 PIGB 治疗是否具有成本效益 - 无论是单独治疗还是作为减重手术的桥梁。
我们开发了一个微观模拟模型，比较了六种治疗策略的成本和效果：PIGB、胃旁路或袖状胃切除术作为单独治疗，PIGB 作为胃旁路或袖状胃切除术的桥梁，以及不治疗。
PIGB 作为减重手术的桥梁比单独的减重手术更具成本效益，因为它有助于实现术后 BMI 更低。在这六种策略中，PIGB 作为袖状胃切除术的桥梁是最具成本效益的，每获得一个 QALY 的增量成本效益比为 3781 美元。虽然与减重手术相比，PIGB 单独治疗不具有成本效益，但与不治疗相比，其每获得一个 QALY 的增量成本效益比为 21711 美元，具有成本效益。
如果将 PIGB 用作减重手术的桥梁，可以节省成本并改善健康结果，并且对于缺乏手术机会或不愿意接受手术的患者，PIGB 单独治疗具有成本效益。
