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Cost-effectiveness of Bariatric Surgery for People with Morbid Obesity in South Korea
- Source :
- Obesity Surgery. 30:256-266
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- This study aimed to evaluate the cost-effectiveness of bariatric surgery (BS) compared to non-surgical treatment (NST) in Korean people with morbid obesity according to comorbidities and body mass index (BMI) severity. The target cohort was people with morbid obesity, defined as BMI of ≥ 35 kg/m2, or obese people with BMI of 30–34.9 kg/m2 having obesity-related comorbidities. A decision-tree model for 1-year obesity treatment and Markov model for the rest of life were used. In the decision-tree model, the comorbidity remission rate and BMI change after 1-year treatment were decided based on a prospective clinical trial. In the Markov model, the transition probabilities were calculated considering the BMI level and age. The starting age of 20 years, a cycle length of 1 year, a time horizon of 80 years, and a 5% discount rate were applied for the base case from the healthcare system perspective. In the base case, BS improved quality-adjusted life years (QALYs) and was the cost-effective option in total cohort (incremental cost-effectiveness ratio of BS vs. NST was 674 USD/QALY). It was shown to be cost-effective in all subgroup analyses based on BMI level. In particular, BS was a dominant alternative for the subgroup with basal BMI of 35.0–37.4 kg/m2. Various sensitivity analyses showed the robustness of results indicating the cost-effectiveness of BS. BS at BMI of > 30 kg/m2 was more effective than NST for a reduction in BMI and remission of obesity-related comorbidities and was cost-effective in Korea.
- Subjects :
- Adult
Male
medicine.medical_specialty
Cost effectiveness
Cost-Benefit Analysis
Endocrinology, Diabetes and Metabolism
Bariatric Surgery
030209 endocrinology & metabolism
Comorbidity
Body Mass Index
Cohort Studies
Morbid obesity
03 medical and health sciences
0302 clinical medicine
Republic of Korea
medicine
Humans
Prospective Studies
Cost–utility analysis
Nutrition and Dietetics
business.industry
Middle Aged
medicine.disease
Obesity
Obesity, Morbid
Surgery
Clinical trial
Cohort
Female
030211 gastroenterology & hepatology
Quality-Adjusted Life Years
business
Body mass index
Subjects
Details
- ISSN :
- 17080428 and 09608923
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Obesity Surgery
- Accession number :
- edsair.doi.dedup.....a76b0156e59a88f6a7740408bd9fb81f