Top

Published in:

01-09-2015 | Review Article

Is Bariatric Surgery Effective in Reducing Comorbidities and Drug Costs? A Systematic Review and Meta-Analysis

Authors: E. C. Lopes, I. Heineck, G. Athaydes, N. G. Meinhardt, K. E. P. Souto, A. T. Stein

Published in: Obesity Surgery | Issue 9/2015

Abstract

The aim of this study was to assess drug use and costs before and after bariatric surgery (BS). A systematic review of the literature was carried out using the MeSH terms obesity, bariatric surgery, and drug costs for searches of 10 electronic databases up to July 2014. Data were extracted from the 11 studies (37,720 patients) that fulfilled the inclusion criteria. Where applicable, data were pooled by meta-analysis. The average number of drugs per patient decreased from 3.9 ± 1.86 before surgery to 1.75 ± 1.85 after surgery. Mean reduction in total cost of drugs was 49.8 % over a follow-up duration of 6–72 months. BS is effective for the improvement or resolution of comorbidities and significantly reduces drug use and costs.

Available only for authorised users

WHO. Obesity and overweight: WHO. 2011 [updated August 2014; cited 2011 06/06/2011]. Available from http://www.who.int/mediacentre/factsheets/fs311/en/index.html.

Santos LMP, Oliveira IV, Peters LR, et al. Trends in morbid obesity and in bariatric surgeries covered by the Brazilian public health system. Obes Surg. 2010;20(7):943–8. doi:10.1007/s11695-008-9570-3.PubMedCrossRef

Potteiger CE, Paragi PR, Inverso NA, et al. Bariatric surgery: shedding the monetary weight of prescription costs in the managed care arena. Obes Surg. 2004;14(6):725–30. doi:10.1381/0960892041590999.PubMedCrossRef

Snow LL, Weinstein LS, Hannon JK, et al. The effect of Roux-en-Y gastric bypass on prescription drug costs. Obes Surg. 2004;14(8):1031–5. doi:10.1381/0960892041975677.PubMedCrossRef

Chevallier JM, Paita M, Rodde-Dunet MH, et al. Predictive factors of outcome after gastric banding: a nationwide survey on the role of center activity and patients' behavior. Ann Surg. 2007;246(6):1034–9. doi:10.1097/SLA.0b013e31813e8a56.PubMedCrossRef

American Society for Metabolic and Bariatric Surgery web site. Bariatric surgery misconceptions: most people who have metabolic and bariatric surgery regain their weight. Available from: https://asmbs.org/patients/bariatric-surgery-misconceptions. Accessed 20 Mar 2015.

Sawaya RA, Jaffe J, Friedenberg L, et al. Vitamin, mineral, and drug absorption following bariatric surgery. Curr Drug Metab. 2012;13(9):1345–55. doi:10.2174/138920012803341339.PubMedCentralPubMedCrossRef

Agren G, Narbro K, Näslund I, et al. Long-term effects of weight loss on pharmaceutical costs in obese subjects. A report from the SOS intervention study. Int J Obes Relat Metab Disord. 2002;26(2):184–92. doi:10.1038/sj.ijo.0801864.PubMedCrossRef

Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13(41):1–190. doi:10.3310/hta13410. 215–357, iii–iv.CrossRef

10.

Padwal R, Klarenbach S, Wiebe N, et al. Bariatric surgery: a systematic review of the clinical and economic evidence. J Gen Intern Med. 2011;26(10):1183–94. doi:10.1007/s11606-011-1721-x.PubMedCentralPubMedCrossRef

11.

Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58. doi:10.1002/sim.1186.PubMedCrossRef

12.

Narbro K, Agren G, Jonsson E, et al. Pharmaceutical costs in obese individuals: comparison with a randomly selected population sample and long-term changes after conventional and surgical treatment: the SOS intervention study. Arch Intern Med. 2002;162(18):2061–9.PubMedCrossRef

13.

Gould JC, Garren MJ, Starling JR. Laparoscopic gastric bypass results in decreased prescription medication costs within 6 months. J Gastrointest Surg. 2004;8(8):983–7. doi:10.1016/j.gassur.2004.09.042.PubMedCrossRef

14.

Myers VH, Adams CE, Barbera BL, et al. Medical and psychosocial outcomes of laparoscopic Roux-en-Y gastric bypass: cross-sectional findings at 4-year follow-up. Obes Surg. 2012;22(2):230–9. doi:10.1007/s11695-010-0324-7.PubMedCrossRef

15.

Nguyen NT, Varela E, Sabio A, et al. Reduction in prescription medication costs after laparoscopic gastric bypass. Am Surg. 2006;72(10):853–6.PubMed

16.

Monk Jr JS, Dia Nagib N, Stehr W. Pharmaceutical savings after gastric bypass surgery. Obes Surg. 2004;14(1):13–5. doi:10.1381/096089204772787220.PubMedCrossRef

17.

Bleich SN, Chang HY, Lau B, et al. Impact of bariatric surgery on health care utilization and costs among patients with diabetes. Med Care. 2012;50(1):58–65.PubMedCentralPubMedCrossRef

18.

Hodo DM, Waller JL, Martindale RG, et al. Medication use after bariatric surgery in a managed care cohort. Surg Obes Relat Dis. 2008;4(5):601–7. doi:10.1016/j.soard.2008.01.008.PubMedCrossRef

19.

Weiner JP, Goodwin SM, Chang HY, et al. Impact of bariatric surgery on health care costs of obese persons: a 6-year follow-up of surgical and comparison cohorts using health plan data. JAMA Surg. 2013;148(6):555–62. doi:10.1001/jamasurg.2013.1504.PubMedCrossRef

20.

Makary MA, Clarke JM, Shore AD, et al. Medication utilization and annual health care costs in patients with type 2 diabetes mellitus before and after bariatric surgery. Arch Surg. 2010;145:726–31.PubMedCrossRef

21.

Zlabek JA, Grimm MS, Larson CJ, et al. The effect of laparoscopic gastric bypass surgery on dyslipidemia in severely obese patients. Surg Obes Relat Dis. 2005;1(6):537–42. doi:10.1016/j.soard.2005.09.009.PubMedCrossRef

22.

Zimmet P, Campbell L, Toomath R, Twigg S, Wittert G, Proietto J. Bariatric surgery to treat severely obese patients with type 2 diabetes: a consensus statement. 2011;5(1):e71-8.

23.

Lam SW, Bauer SR, Cha SS, et al. Lack of an effect of body mass on the hemodynamic response to arginine vasopressin during septic shock. Pharmacotherapy. 2008;28(5):591–9.PubMedCrossRef

24.

Yska JP, van der Linde S, Tapper VV, et al. Influence of bariatric surgery on the use and pharmacokinetics of some major drug classes. Obes Surg. 2013;23(6):819–25. doi:10.1007/s11695-013-0882-6.PubMedCrossRef

25.

Buchwald H, Ikramuddin S, Dorman RB, et al. Management of the metabolic/bariatric surgery patient. Am J Med. 2011;124(12):1099–105. doi:10.1016/j.amjmed.2011.05.035.PubMedCrossRef

26.

Neovius M, Narbro K, Keating C, et al. Health care use during 20 years following bariatric surgery. JAMA. 2012;308(11):1132–41. doi:10.1001/2012.jama.11792.PubMedCrossRef

27.

Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37. doi:10.1001/jama.292.14.1724.PubMedCrossRef

28.

Ciangura C, Corigliano N. Obesity surgery and its adverse effects. Rev Med Interne. 2012;33(6):318–27. doi:10.1016/j.revmed.2011.12.008.PubMedCrossRef

29.

Buchwald H. Overview of bariatric surgery. J Am Coll Surg. 2002;194(3):367–75.PubMedCrossRef

30.

Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.PubMedCentralPubMedCrossRef

31.

Aminian A, Daigle CR, Romero-Talamás H, et al. Risk prediction of complications of metabolic syndrome before and 6 years after gastric bypass. Surg Obes Relat Dis. 2014;10(4):576–82. doi:10.1016/j.soard.2014.01.025.PubMedCrossRef

32.

Piché M, Martin J, Cianflone K, et al. Changes in predicted cardiovascular disease risk after biliopancreatic diversion surgery in severely obese patients. Metabolism. 2014;63(1):79–86. doi:10.1016/j.metabol.2013.09.004.PubMedCrossRef

33.

Salinari S, Bertuzzi A, Guidone C, et al. Insulin sensitivity and secretion changes after gastric bypass in normotolerant and diabetic obese subjects. Ann Surg. 2013;257(3):462–8. doi:10.1097/SLA.0b013e318269cf5c.PubMedCrossRef

34.

Mor A, Omotosho P, Torquati A. Cardiovascular risk in obese diabetic patients is significantly reduced one year after gastric bypass compared to one year of diabetes support and education. Surg Endosc. 2014;28(10):2815–20. doi:10.1007/s00464-014-3550-6.PubMedCrossRef

35.

Cunneen SA, Phillips E, Fielding G, et al. Studies of Swedish adjustable gastric band and Lap-Band: systematic review and meta-analysis. Surg Obes Relat Dis. 2008;4(2):174–85. doi:10.1016/j.soard.2007.10.016.PubMedCrossRef

Title: Is Bariatric Surgery Effective in Reducing Comorbidities and Drug Costs? A Systematic Review and Meta-Analysis
Authors: E. C. Lopes
I. Heineck
G. Athaydes
N. G. Meinhardt
K. E. P. Souto
A. T. Stein
Publication date: 01-09-2015
Publisher: Springer US
Published in: Obesity Surgery / Issue 9/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-015-1777-5

At a glance: The STEP trials

Springer Medicine

Is Bariatric Surgery Effective in Reducing Comorbidities and Drug Costs? A Systematic Review and Meta-Analysis

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 9/2015

The Impact of Bariatric Surgery on Diabetic Retinopathy: A Systematic Review and Meta-Analysis

Airway Hyperresponsiveness to Mannitol in Obesity Before and After Bariatric Surgery

Intraoperative Endoscopy Decreases Postoperative Complications in Laparoscopic Roux-en-Y Gastric Bypass

Bariatric Surgery can Lead to Net Cost Savings to Health Care Systems: Results from a Comprehensive European Decision Analytic Model

Standardized Technique of Laparoscopic Adjustable Gastric Banded Plication with 4-Year Results

Sleeve Gastrectomy With or Without a Multimodal Perioperative Care. A Randomized Pilot Study