Bariatric treatments for adult obesity - Institute of Health Economics

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S4Economic burden of obesityMean cost/visits per residentOutpatient and Physician Physician Outpatient Outpatient InpatientBMIphysician costs costs visit costs visits admissionUnderweight $523.24 $362.43 7.272 $192.35 0.705 0.066Normal weight $479.53 $315.77 6.574 $150.09 0.611 0.052Overweight $544.91 $372.93 7.632 $189.38 0.812 0.066Obese $696.44 $492.34 9.877 $245.68 1.130 0.081Note: The mean cost/visit was adjusted to residents completing CCHS, using patient costs or visits listed in S2. The method is:Incremental costs/visits over normal weightOutpatient and Physician Physician Outpatient Outpatient InpatientBMIphysician costs costs visit costs visits admissionUnderweight $43.71 $46.65 0.698 $42.25 0.094 0.015Overweight $65.37 $57.16 1.058 $39.29 0.201 0.014Obese $216.90 $176.57 3.303 $95.58 0.519 0.029Note: This table presents the difference between normal weight and other BMI categories.Economic burden of obesity (costs are in millions and visits are per 1000)Underweight versusnormal weight$2.53 $2.70 40.33 $2.44 5.45 0.85Overweight versusnormal weight$55.10 $48.18 891.84 $33.11 169.56 11.72Obese versusnormal weight$100.47 $81.79 1530.24 $44.28 240.44 13.61Note: Multiplying Alberta residents with obesity in S3 by the marginal cost/visit between obese and normal weight.Bariatric treatments for adult obesity 200
REFERENCES1. Klarenbach S, Adwal R, Wiebe N, Hazel M, Birch D, Manns B, et al. Bariatric surgery for severeobesity: Systematic review and economic evaluation. Ottawa, ON: Canadian Agency for Drugs andTechnologies in Health, 2010.2. Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the economicevaluation of health care programs, 549. 03 ed. Oxford University Press, 2005.3. Drummond MF, Barbieri M, Cook J, Glick HA, Lis J, Malik F, et al. Transferability ofeconomic evaluations across jurisdictions: ISPOR Good Research Practices Task Force report1. Value Health 2009;12(4):409-18.4. Anselmino M, Bammer T, Fernandez Cebrian JM, Daoud F, Romagnoli G, Torres A. Costeffectivenessand budget impact of obesity surgery in patients with type 2 diabetes in threeEuropean countries (II). Obesity Surgery 2009;19(11):1542-49.5. Picot J. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery forobesity: A systematic review and economic evaluation. Health Technology Assessment2009;13(41):ix-214.6. Salem L, Devlin A, Sullivan SD, Flum DR. Cost-effectiveness analysis of laparoscopic gastricbypass, adjustable gastric banding, and nonoperative weight loss interventions. Surgery forObesity & Related Diseases 2008;4(1):26-32.7. Ackroyd R, Mouiel J, Chevallier JM, Daoud F. Cost-effectiveness and budget impact of obesitysurgery in patients with type-2 diabetes in three European countries. Obesity Surgery2006;16(11):1488-1503.8. Jensen C, Flum DR, ABS Consensus C. The costs of nonsurgical and surgical weight lossinterventions: is an ounce of prevention really worth a pound of cure? Surgery for Obesity &Related Diseases 2005;1(3):353-7.9. Paxton JH. The cost-effectiveness of laparoscopic versus open gastric bypass surgery. ObesitySurgery 2005;15(1):24-34.10. Craig BM. Cost-effectiveness of gastric bypass for severe obesity. American Journal of Medicine2002;113(6):491-8.11. Van Mastrigt GAPG. One-year cost-effectiveness of surgical treatment of morbid obesity:Vertical banded gastroplasty versus Lap-Band. Obesity Surgery 2006;16(1):75-84.12. Clegg AJ, Colquitt J, Sidhu MK, Royle P, Loveman E, Walker A. The clinical effectiveness andcost-effectiveness of surgery for people with morbid obesity: a systematic review andeconomic evaluation. Health Technology Assessment 2002;6(12):1-153.13. Keating CL, Dixon JB, Moodie ML, Peeters A, Bulfone L, Maglianno DJ, et al. Costeffectivenessof surgically induced weight loss for the management of type 2 diabetes: modeledlifetime analysis. Diabetes Care 2009;32(4):567-74.14. van Baal PH, van den Berg M, Hoogenveen RT, Vijgen SM, Engelfriet PM. Cost-effectivenessof a low-calorie diet and orlistat for obese persons: modeling long-term health gains throughprevention of obesity-related chronic diseases. Value Health 2008;11(7):1033-40.Bariatric treatments for adult obesity 201
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Alberta STE ReportBariatric treatme
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Alberta STE ReportBariatric treatme
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EXECUTIVE SUMMARYSocial and System
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Three surgical procedures—adjusta
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Costs of Bariatric Surgery and Pote
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Regulatory status .................
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TABLES AND FIGURESSection One: Soci
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ABBREVIATIONSAll abbreviations that
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LYMmMAMDMUHCNANHLBINHSNICENIHNNHNPH
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Bariatric physician: a licensed Doc
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High-density lipoprotein (HDL): a f
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Very-low-calorie diet (VLCD): a die
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Additional Internet searches were c
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This report addresses obesity in ad
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Many systemic factors have been ide
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Severe obesity is associated with d
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eport their height and under-report
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Also using self-reported data from
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An examination of overall obesity d
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Table S.2 presents the associationa
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• have multiple focal points and
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The main problem in any weight mana
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food, and a negative body image. As
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directly causes death. 61 To the ex
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The addition of a selected pharmaco
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lack of formal training in nutritio
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slightly more likely to have prescr
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selection criteria, have facilities
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Barriers to using appropriate baria
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Overview of adult obesityOver the p
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the need for regular physical activ
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phenylpropanolamine/25. Sibutramine
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Complianceand AdherenceDemand andut
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Aetna Clinical PolicyBulletinswww.a
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Overweight 123,821 172,971 157,623
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REFERENCES1. 2006 Canadian clinical
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34. Gostin LO. Fast and supersized:
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69. Klarenbach S, Padwal R, Wiebe N
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105. Hill JO, Thompson H, Wyatt H.
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141. Ross R, Bradshaw AJ. The futur
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172. Arkinson J, Ji H, Fallah S, Pe
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This section will address a set of
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dietary therapy is to reduce total
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Additional benefits of exercise ove
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medications that inhibit intestinal
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Rimonabant may be considered for pa
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Long-term complications are specifi
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Devices used for bariatric surgeryH
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Description of the Included Systema
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AEs for sibutramineAs compared to a
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Evidence on Efficacy/EffectivenessW
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Table T.7: Effects of behavioural t
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SurgeryDescription of the included
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follow-up time was 3 years. Results
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group as compared to the VBG group.
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The authors identified many methodo
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The investigators pointed out that
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approximately 3 to 5 kilograms. For
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for studies with a mean age of part
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Examining whether use of any of the
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Evidence from placebo-controlled cl
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colorectal or gastroesophageal or f
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Web of ScienceISI Interface License
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AMA Clinical PracticeGuidelineswww.
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critical appraisal of the included
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APPENDIX T.B: EXCLUDED STUDIESTable
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Padwal R, Li SK, Lau DC. Long-term
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Quality subsection 1: At least MEDL
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Quality subsection 5a:Study quality
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Partially reported: The study types
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Table T.C.1: Results of quality ass
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Table T.C.1: Results of quality ass
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APPENDIX T.D: CHARACTERISTICS OF SY
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Table T.D.1: Characteristics of the
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APPENDIX T.E: EVIDENCE TABLE ON SAF
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Serious surgical complicationsSurgi
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LSGmMAMDNAnssORQoLRCTRDRRRYGBSBPTGV
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Table T.F.1-2: Weight loss - Behavi
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Table T.F.1-4: Weight loss - Surger
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Table T.F.2: Quality of life (QoL)
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Curioni & Lourenco 2005 58Cholester
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Table T.F.3-3: Risk factors/comorbi
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Table T.F.3-5: Long-term effects of
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Page 212 and 213: ResultHealth outcomesCostsMarginal
Page 214 and 215: CostsMarginal analysisThe cost anal
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Page 218 and 219: Objectivestudy perspective: society
Page 226 and 227: 15. Lacey LA, Wolf A, O'shea D, Ern
Page 228 and 229: Author Contribution StatementsPaula
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