Actual medical and pharmacy costs for bariatric surgery: 6-year follow-up.

Published

Journal Article

OBJECTIVE: To determine the change in total medical expenditures, total pharmacy expenditures, and subcategories of medical and pharmacy expenditures in obese individuals following weight loss surgery (WLS), and to compare these costs with expenditures in obese individuals not receiving WLS. METHODS: Louisiana Office of Group Benefits (OGB), the state-managed health insurer, invited members to be evaluated for insurance-covered WLS. Of 951 obese members who provided written consent to begin the WLS screening process, 40 were selected for surgery. Medical and pharmaceutical claims cost data of the 911 patients who did not have surgery and the 39 individuals who completed surgery were compared over a 2-year presurgical and 6-year postsurgical period. RESULTS: Total nonpharmacy medical costs were lower for WLS patients compared with non-WLS patients beginning 4 years postsurgery and lasting through 6 years postsurgery. No differences were found between WLS and non-WLS patients in expenditures for most medical subcategories examined, including emergency department, physical and occupational therapy, office visits, and laboratory/pathology; whereas sleep facility and all remaining medical expenditures not represented by a subcategory were lower for WLS patients during some postsurgery years. Total pharmacy costs were lower for WLS participants at 2 and 3 years postsurgery, but these lower costs were not maintained; however, costs remained lower for antidiabetic agents, antihypertensive agents, and dyslipidemic agents through all 6 postsurgery years under study. CONCLUSIONS: The cost of WLS may begin to be recouped within the first 4 years postsurgery with continued effects 6 years postsurgery.

Full Text

Cited Authors

  • Myers, VH; McVay, MA; Adams, CE; Barbera, BL; Brashear, MM; Johnson, WD; Boyd, PS; Brantley, PJ

Published Date

  • October 2012

Published In

Volume / Issue

  • 105 / 10

Start / End Page

  • 530 - 537

PubMed ID

  • 23038484

Pubmed Central ID

  • 23038484

Electronic International Standard Serial Number (EISSN)

  • 1541-8243

International Standard Serial Number (ISSN)

  • 0038-4348

Digital Object Identifier (DOI)

  • 10.1097/smj.0b013e318268c76d

Language

  • eng