1. Cost-effectiveness of bariatric surgery versus community weight management to treat obesity-related idiopathic intracranial hypertension: evidence from a single-payer healthcare system.
- Author
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Elliot L, Frew E, Mollan SP, Mitchell JL, Yiangou A, Alimajstorovic Z, Ottridge RS, Wakerley BR, Thaller M, Grech O, Singhal R, Tahrani AA, Harrison M, Sinclair AJ, and Aguiar M
- Subjects
- Cost-Benefit Analysis, England, Female, Health Care Costs, Humans, Obesity complications, Obesity surgery, State Medicine, Bariatric Surgery, Pseudotumor Cerebri
- Abstract
Background: Idiopathic intracranial hypertension (IIH) is associated with significant morbidity, predominantly affecting women of childbearing age living with obesity. Weight loss has demonstrated successful disease-modifying effects; however, the long-term cost-effectiveness of weight loss interventions for the treatment of IIH has not yet been established., Objectives: To estimate the cost-effectiveness of weight-loss treatments for IIH., Setting: Single-payer healthcare system (National Health Service, England)., Methods: A Markov model was developed comparing bariatric surgery with a community weight management intervention over 5-, 10-, and 20-year time horizons. Transition probabilities, utilities, and resource use were informed by the IIH Weight Trial (IIH:WT), alongside the published literature. A probabilistic sensitivity analysis was conducted to characterize uncertainty within the model., Results: In the base case analysis, over a 20-year time horizon, bariatric surgery was "dominant," led to cost savings of £49,500, and generated an additional 1.16 quality-adjusted life years in comparison to the community weight management intervention. The probabilistic sensitivity analysis indicated a probability of 98% that bariatric surgery is the dominant option in terms of cost-effectiveness., Conclusion: This economic modeling study has shown that when compared to community weight management, bariatric surgery is a highly cost-effective treatment option for IIH in women living with obesity. The model shows that surgery leads to long-term cost savings and health benefits, but that these do not occur until after 5 years post surgery, and then gradually increase over time., (Copyright © 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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