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 cost-saving over the lifetime of the Italian patient cohort considered in this analysis.

Lucchese, M., Borisenko, O., Mantovani, L., Cortesi, P., Cesana, G., Adam, D., et al. (2017). Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling. OBESITY FACTS, 10(3), 261-272 [10.1159/000475842].

Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling

Mantovani, Lorenzo Giovanni;Cortesi, Paolo Angelo;Cesana, Giancarlo;
2017

Abstract

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 cost-saving over the lifetime of the Italian patient cohort considered in this analysis.
Articolo in rivista - Articolo scientifico
Bariatric surgery; Cost-Benefit analysis; Italy; Adult; Bariatric Surgery; Cardiovascular Diseases; Cohort Studies; Diabetes Mellitus, Type 2; Gastrectomy; Gastric Bypass; Gastroplasty; Humans; Italy; Male; Markov Chains; Middle Aged; Obesity; Postoperative Complications; Quality-Adjusted Life Years; Treatment Outcome; Cost-Benefit Analysis; Health (social science); Physiology (medical)
English
2017
10
3
261
272
open
Lucchese, M., Borisenko, O., Mantovani, L., Cortesi, P., Cesana, G., Adam, D., et al. (2017). Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling. OBESITY FACTS, 10(3), 261-272 [10.1159/000475842].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/219192
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