Objective: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. Methods: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. Results: In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. Conclusion: In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and costsaving over the lifetime of the Italian patient cohort considered in this analysis. (C) 2017 The Author(s) Published by S. Karger GmbH, Freiburg
Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling / Lucchese, M; Borisenko, O; Mantovani, Lg; Cortesi, Pa; Cesana, Gc; Adam, D; Burdukova, E; Lukyanov, V; Di Lorenzo, N. - In: OBESITY FACTS. - ISSN 1662-4025. - 10:3(2017), pp. 261-272. [10.1159/000475842]
Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling
Di Lorenzo N
2017
Abstract
Objective: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. Methods: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. Results: In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. Conclusion: In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and costsaving over the lifetime of the Italian patient cohort considered in this analysis. (C) 2017 The Author(s) Published by S. Karger GmbH, FreiburgI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
