Forbes Hayley, He Wenjing, Dharmasena Isuru, Prior Heather J, Vergis Ashley, Hardy Krista
Department of Surgery, Max Rady College of Medicine, St. Boniface General Hospital, University of Manitoba, 409 Tache Avenue, Winnipeg, MB, Canada.
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada.
Surg Endosc. 2024 Dec;38(12):7604-7612. doi: 10.1007/s00464-024-11144-8. Epub 2024 Sep 30.
Obesity is a chronic disease that is significantly linked to metabolic syndrome. Bariatric surgery is considered the most effective treatment for obesity resulting in long-term weight loss and comorbidity resolution. Prior studies have demonstrated the overall cost effectiveness of bariatric surgery; however, there is little data regarding direct pharmaceutical costs. The objective of this population-based study is to compare the cost of dispensed common prescription medications for metabolic syndrome before and after bariatric surgery.
All patients that were enrolled in the Center for Metabolic and Bariatric Surgery who underwent gastric bypass or sleeve gastrectomy between 2013 and 2019 in Manitoba were included. Basic demographic information and outpatient prescription dispensation data were obtained from the Manitoba Population Research Data Repository, which is housed at the Manitoba Centre for Health Policy. Specific drug categories that were reviewed for costs 5 years before and after surgery included Antihypertensives, Lipid Lowering Agents, Insulin and Non-insulin Diabetic Drugs.
One thousand one hundred and eighty four patients were included in this review. Comparing the 5-year pre- and post-surgery, there was a decrease in the overall amount of drug dispensed and the overall cost for all drug categories in the 5 years following surgery. These categories included Antihypertensives ($506,268.8), Lipid Lowering Agents ($173,866.48), Insulin ($549,305.92), and Other Diabetes Drugs ($513,371.1). Additionally, older patients experienced a larger proportion of cost savings compared to younger patients, with the exception of non-insulin diabetic medications which trended to have more cost savings in the 30-49 year old grouping.
This is the first Canadian study to use accurate dispensing data from a provincial administrative prescription database to capture long-term cost savings for metabolic prescriptions after bariatric surgery. The results are consistent with the existing literature for prescriptions post-bariatric surgery. Future study will include subgroup analysis by patient age, gender, income quintile, and geography.
肥胖是一种与代谢综合征显著相关的慢性疾病。减肥手术被认为是治疗肥胖最有效的方法，可实现长期体重减轻并解决合并症。先前的研究已经证明了减肥手术的总体成本效益；然而，关于直接药物成本的数据很少。这项基于人群的研究的目的是比较减肥手术前后代谢综合征常用处方药的配药成本。
纳入了2013年至2019年在曼尼托巴省代谢与减肥手术中心接受胃旁路手术或袖状胃切除术的所有患者。基本人口统计信息和门诊处方配药数据来自位于曼尼托巴省卫生政策中心的曼尼托巴省人口研究数据存储库。对手术前后5年的成本进行审查的特定药物类别包括抗高血压药、降脂药、胰岛素和非胰岛素糖尿病药物。
本综述纳入了1184名患者。比较手术前后5年，术后5年所有药物类别的配药总量和总成本均有所下降。这些类别包括抗高血压药（506,268.8加元）、降脂药（173,866.48加元）、胰岛素（549,305.92加元）和其他糖尿病药物（513,371.1加元）。此外，与年轻患者相比，老年患者节省的成本比例更大，但非胰岛素糖尿病药物在30 - 49岁年龄组中节省的成本趋势更大。
这是加拿大第一项使用省级行政处方数据库中的准确配药数据来获取减肥手术后代谢处方长期成本节省情况的研究。结果与减肥手术后处方的现有文献一致。未来的研究将包括按患者年龄、性别、收入五分位数和地理位置进行亚组分析。
