Bariatric surgery tied to drop in healthcare costs for patients

Last Updated: 2015-06-10

By Rob Goodier

NEW YORK (Reuters Health) - Bariatric surgery may be associated with reduced healthcare costs for patients in the long term, a new study suggests.

But the procedures are not equal. Patients who underwent gastric banding had run up higher costs than those who underwent laparoscopic Roux-en-Y gastric bypass surgery three years after the procedure, researchers found.

"Although bypass patients had an initial increase in ED visits, they had trended back down by the third year after surgery," lead author Dr. Kristina Lewis from Kaiser Permanente Georgia in Atlanta told Reuters Health by email.

"Coupled with maintaining lower prescription costs compared to band, and a known greater effect on weight loss and remission of conditions like diabetes, this probably led to overall lower costs for bypass patients by that third year," she said.

Dr. Lewis and her team mined data from national insurance claims and included nearly 10,000 bypass and banding patients, matching them according to baseline demographic and medical characteristics.

Both procedures were associated with downwards trends in costs, while there had been an upward trend prior to the surgery. By the third year, banding patients had 16% higher total costs than bypass patients (absolute change: $818 per year; p<0.01), the researchers report in JAMA Surgery, online June 3.

Bypass patients used the emergency department more often in the first two years, but by the third year the difference was no longer significant.

"Given the known significant clinical impact of bypass surgery on weight and health, it would be wonderful to explore ways of minimizing these patients' risk of additional emergency department visits and hospitalizations in the first years after surgery," Dr. Lewis said. "Perhaps if we could decrease those, the impact of the procedure on total medical costs would be even greater, earlier on -- leading insurers to feel more comfortable covering bypass surgery for more people."

The findings may help settle a debate in the medical community over the net costs or net savings of these procedures.

"This study suggests that bariatric surgery may be the rare and elusive win/win -- improving outcomes and reducing costs," Dr. Justin Dimick of the University of Michigan in Ann Arbor, who wrote an accompanying editorial on the study, told Reuters Health by email.

SOURCE: http://bit.ly/1B2wr6Z and http://bit.ly/1GyPV5h

JAMA Surg 2015.