التفاصيل البيبلوغرافية
| العنوان: |
Cost-effectiveness of gastric band surgery for overweight but not obese adults with type 2 diabetes in the U.S. |
| المؤلفون: |
Wentworth, John M.1,2,3 wentworth@wehi.edu.au, Dalziel, Kim M.4, O'Brien, Paul E.1, Burton, Paul1, Shaba, Frackson4, Clarke, Philip M.4, Laiteerapong, Neda5, Brown, Wendy A.1, O'Brien, Paul E1 (AUTHOR) |
| المصدر: |
Journal of Diabetes & its Complications. Jul2017, Vol. 31 Issue 7, p1139-1144. 6p. |
| مصطلحات موضوعية: |
*TYPE 2 diabetes treatment, *OBESITY, *BARIATRIC surgery, *OBESITY treatment, *COMBINED modality therapy, *TYPE 2 diabetes, *TYPE 2 diabetes complications, *OBESITY complications, *CLINICAL trials, *COST effectiveness, *ECONOMIC aspects of diseases, *MEDICAL care costs, *QUALITY of life, *RESEARCH funding, *SURVEYS, *WEIGHT loss, *COST analysis, *BODY mass index, *STATISTICAL models, *ECONOMICS |
| مصطلحات جغرافية: |
AUSTRALIA, UNITED States |
| مستخلص: |
Aim: To determine the cost-effectiveness of gastric band surgery in overweight but not obese people who receive standard diabetes care.Method: A microsimulation model (United Kingdom Prospective Diabetes Study outcomes model) was used to project diabetes outcomes and costs from a two-year Australian randomized trial of gastric band (GB) surgery in overweight but not obese people (BMI 25 to 30kg/m2) on to a comparable population of U.S. adults from the National Health and Nutrition Examination Survey (N=254). Estimates of cost-effectiveness were calculated based on the incremental cost-effectiveness ratios (ICERs) for different treatment scenarios. Costs were inflated to 2015 U.S. dollar values and an ICER of less than $50,000 per QALY gained was considered cost-effective.Results: The incremental cost-effectiveness ratio for GB surgery at two years exceeded $90,000 per quality-adjusted life year gained but decreased to $52,000, $29,000 and $22,000 when the health benefits of surgery were assumed to endure for 5, 10 and 15 years respectively. The cost-effectiveness of GB surgery was sensitive to utility gained from weight loss and, to a lesser degree, the costs of GB surgery. However, the cost-effectiveness of GB surgery was affected minimally by improvements in HbA1c, systolic blood pressure and cholesterol.Conclusions: GB surgery for overweight but not obese people with T2D appears to be cost-effective in the U.S. setting if weight loss endures for more than five years. Health utility gained from weight loss is a critical input to cost-effectiveness estimates and therefore should be routinely measured in populations undergoing bariatric surgery. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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