Bariatric treatments for adult obesity - Institute of Health Economics

groups. Compared with standard care, the costs per QALY gained of LM ranged from $910 for 55-year-old men to $6255 for 25-year-old women for overweight patients; from dominant (due to moreeffective and less costly) in 35-year-old women and 55-year-old men to $3164 in 25-year-old womenfor moderate obese patients, and the costs from dominant (due to more effective and less costly) inall males to $3008 in 25-year-old women for borderline patients. The study concluded that LM wascost-effective option in long run.Quality assessmentThe quality of the selected studies was assessed using criteria adapted from Drummond et al. 2,3 Theassessment considered the methodological approaches applied to enhance the internal validity andtransferability of the studies. This included a data extraction of the following:study question;study type;perspective;time horizon;reliability of clinical evidence;cost calculation; methods of handling uncertainty.Overall, the studies met our quality criteria. Cost categories included in the studies were consistentwith the stated perspective. Evidence of effectiveness came from RCTs, which provided greaterinternal validity of clinical inputs used in the studies. However, measures of health-related quality oflife (HRQOL), which was the measure of health benefit, were not sufficiently described in thestudies. Consequently, the measures of health benefit may not accurately reflect the populationsincluded in these studies.It is also important to mention that it is uncertain how generalizable the results are to the Albertacontext. Studies were conducted in various European countries, Australia, and the US, and, althoughthey generally met our quality criteria, they did not provide the detail necessary to determine whethertheir analysis is comparable to the epidemiological and health system characteristics of Alberta.Results from Analysis of Provincial Health Utilization DataCosts of bariatric surgeryTable E.3 presents the number of the surgical patients, by city, in 2006. Two hundred seventeenpatients, having a mean age of 39 years, and 87% of whom were women, underwent a bariatricsurgical procedure in Alberta.Table E.4 shows the mean cost of bariatric surgery in 2006. Mean costs per bariatric surgery forinpatient and physician services were $10,763 and $2189, respectively. When combining bothinpatient and physician services, the mean cost was $12,176 per bariatric surgery.Bariatric treatments for adult obesity 170