Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling
| Autor: | Marcello Lucchese, Oleg Borisenko, Lorenzo Giovanni Mantovani, Paolo Angelo Cortesi, Giancarlo Cesana, Daniel Adam, Elisabeth Burdukova, Vasily Lukyanov, Nicola Di Lorenzo |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Obesity Facts, Vol 10, Iss 3, Pp 261-272 (2017) |
| Druh dokumentu: | article |
| ISSN: | 1662-4025 1662-4033 |
| DOI: | 10.1159/000475842 |
| Popis: | Objective: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. Methods: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. Results: In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. Conclusion: In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis. |
| Databáze: | Directory of Open Access Journals |
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