The aim of the analysis was to demonstrate that, from the public payer’s perspective, bariatric surgeries are cost-effective treatment options for obese patients with type 2 diabetes.
The researchers compared the health outcomes and associated costs of bariatric surgery with those of conventional drug treatments over an extended period.
Patients entered the simulation model at the age of 45 with a body mass index (BMI) greater than or equal to 30 kg/m2 and type 2 diabetes. Outcomes were calculated for three BMI groups: greater than or equal to 30 to 35 kg/m2, 35 to 40 kg/m2 and 40 to 50 kg/m2.
The health outcomes were expressed in quality-adjusted life years (QALYs), and the costs were calculated based on expenses covered by public healthcare for inpatient and outpatient services and drug reimbursement.
Across all variables examined—such as mortality reduction, avoidance of complications, and quality of life—bariatric surgery consistently yielded greater health benefits compared to conservative drug treatments.
Our research confirms that bariatric surgery is more effective than traditional drug therapy, and its positive impact on body weight and quality of life can be sustained over the long term
, says Dr. Zoltán Kaló, professor at the Center for Health Technology Assessment at Semmelweis University, corresponding author of the study.
Bariatric surgery also generates positive financial return on investment, the study notes.
Savings are generated not only from the reduced cost of diabetes medications, but also from prevented complications
, says Dr. Gábor Kovács, senior researcher at the Center for Health Technology Assessment at Semmelweis University.
Based on the estimates of the economic model, for every 100 patients, the most common bariatric procedures result in EUR 1.7 – 2.4 million savings in public payer expenditures and 1.36 to 1.50 quality-adjusted life years (QALY) gain in the three BMI categories.
The cost-saving potential of bariatric surgery may vary based on differences in health care costs across countries, but in general the initial costs of surgery are quickly offset by the lasting health benefits and savings, the study highlights.
Both the sustained reduction in body weight and improved blood glucose levels achieved through surgery last well beyond five years, in contrast to traditional drug treatments where symptoms tend to worsen despite continuous use of medication.
Despite some potential weight regain and blood sugar level increase after the postoperative phase, the results of surgery last long term. Surgery also has a positive impact on related diabetes complications including hypertension, renal failure and ophtalmological problems, and obesity-related complications such as musculoskeletal and joint problems, the research shows. “By reducing the complications of obesity-related diabetes, surgery led to an increase in both life expectancy and disease-free survival,” Dr. Zoltán Kaló adds.
Rather than the root causes, current pharmacological treatments primarily address the symptoms of diabetes and must be taken lifelong, the authors say.
“Bariatric surgery represents a fundamentally different therapeutic option. If it is available with public reimbursement, it could complement pharmaceutical treatments, offering a preventive approach that can also manage complications very effectively,” Dr. Zoltán Kaló highlights.
Illustration: iStock
