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Cost-Effectiveness of Bariatric Surgery in Tunisia

PURPOSE: Obesity is a growing global issue with evidence linking it to an increase in loss of disease-free years, reduced quality of life, increased mortality, and additional economic burden. This study sought to establish the cost-effectiveness of gastric bypass and sleeve gastrectomy, compared to...

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Autores principales: Galvain, Thibaut, Bosut, Melek Pinar, Jamous, Nadine, Ben Mansour, Nadia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075262/
https://www.ncbi.nlm.nih.gov/pubmed/37033399
http://dx.doi.org/10.2147/DMSO.S385110
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author Galvain, Thibaut
Bosut, Melek Pinar
Jamous, Nadine
Ben Mansour, Nadia
author_facet Galvain, Thibaut
Bosut, Melek Pinar
Jamous, Nadine
Ben Mansour, Nadia
author_sort Galvain, Thibaut
collection PubMed
description PURPOSE: Obesity is a growing global issue with evidence linking it to an increase in loss of disease-free years, reduced quality of life, increased mortality, and additional economic burden. This study sought to establish the cost-effectiveness of gastric bypass and sleeve gastrectomy, compared to conventional therapy in patients with obesity, from a Tunisian healthcare payor perspective. PATIENTS AND METHODS: A Markov model compared lifetime costs and outcomes of bariatric surgery with conventional treatment among patients with body mass index (BMI) ≥ 40 kg/m(2), BMI ≥ 35 kg/m(2) with obesity-related co-morbidities (Group 1), or BMI ≥ 35 kg/m(2) with type 2 diabetes mellitus (T2DM) (Group 2). Inputs were sourced from the Tunisian Health Examination Survey, local clinician data and literature sources. Health states were associated with different cost and utility decrements. Changes in body mass index, systolic blood pressure, lipid ratio and diabetes remission rates were modelled on a yearly basis. The incremental cost-effectiveness ratio (ICER), quality-adjusted life years (QALYs) and net monetary benefit (NMB) were key outcomes. Sensitivity and scenario analyses were performed to test the model’s robustness. RESULTS: The model showed that the benefits of bariatric surgery were favorable compared to conventional treatment, with an ICER of 1844 TND/QALY in Group 1 patients and 2413 TND/QALY in Group 2 patients. Bariatric surgery resulted in a QALY gain of 3.26 per patient in Group 1 and a gain of 1.77 per patient in Group 2. At a willingness to pay threshold of 31,379 TND/QALY, the incremental NMB was 96,251 TND and 51,123 TND for Group 1 and Group 2, respectively. CONCLUSION: From the Tunisian healthcare payor perspective, bariatric surgery is cost-effective for patients with obesity and those with T2DM and obesity-related comorbidities. These findings may have impact on future decision-making on funding and reimbursement of bariatric surgery in Tunisia.
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spelling pubmed-100752622023-04-06 Cost-Effectiveness of Bariatric Surgery in Tunisia Galvain, Thibaut Bosut, Melek Pinar Jamous, Nadine Ben Mansour, Nadia Diabetes Metab Syndr Obes Original Research PURPOSE: Obesity is a growing global issue with evidence linking it to an increase in loss of disease-free years, reduced quality of life, increased mortality, and additional economic burden. This study sought to establish the cost-effectiveness of gastric bypass and sleeve gastrectomy, compared to conventional therapy in patients with obesity, from a Tunisian healthcare payor perspective. PATIENTS AND METHODS: A Markov model compared lifetime costs and outcomes of bariatric surgery with conventional treatment among patients with body mass index (BMI) ≥ 40 kg/m(2), BMI ≥ 35 kg/m(2) with obesity-related co-morbidities (Group 1), or BMI ≥ 35 kg/m(2) with type 2 diabetes mellitus (T2DM) (Group 2). Inputs were sourced from the Tunisian Health Examination Survey, local clinician data and literature sources. Health states were associated with different cost and utility decrements. Changes in body mass index, systolic blood pressure, lipid ratio and diabetes remission rates were modelled on a yearly basis. The incremental cost-effectiveness ratio (ICER), quality-adjusted life years (QALYs) and net monetary benefit (NMB) were key outcomes. Sensitivity and scenario analyses were performed to test the model’s robustness. RESULTS: The model showed that the benefits of bariatric surgery were favorable compared to conventional treatment, with an ICER of 1844 TND/QALY in Group 1 patients and 2413 TND/QALY in Group 2 patients. Bariatric surgery resulted in a QALY gain of 3.26 per patient in Group 1 and a gain of 1.77 per patient in Group 2. At a willingness to pay threshold of 31,379 TND/QALY, the incremental NMB was 96,251 TND and 51,123 TND for Group 1 and Group 2, respectively. CONCLUSION: From the Tunisian healthcare payor perspective, bariatric surgery is cost-effective for patients with obesity and those with T2DM and obesity-related comorbidities. These findings may have impact on future decision-making on funding and reimbursement of bariatric surgery in Tunisia. Dove 2023-04-01 /pmc/articles/PMC10075262/ /pubmed/37033399 http://dx.doi.org/10.2147/DMSO.S385110 Text en © 2023 Galvain et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Galvain, Thibaut
Bosut, Melek Pinar
Jamous, Nadine
Ben Mansour, Nadia
Cost-Effectiveness of Bariatric Surgery in Tunisia
title Cost-Effectiveness of Bariatric Surgery in Tunisia
title_full Cost-Effectiveness of Bariatric Surgery in Tunisia
title_fullStr Cost-Effectiveness of Bariatric Surgery in Tunisia
title_full_unstemmed Cost-Effectiveness of Bariatric Surgery in Tunisia
title_short Cost-Effectiveness of Bariatric Surgery in Tunisia
title_sort cost-effectiveness of bariatric surgery in tunisia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075262/
https://www.ncbi.nlm.nih.gov/pubmed/37033399
http://dx.doi.org/10.2147/DMSO.S385110
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