Adjustable Gastric Banding Provides Cost-Effective Treatment for Diabetes

Thursday, 02 September 2010 13:28

A study published in the September issues of Diabetes Care indicates that both adjustable gastric banding and gastric bypass may be cost-effective methods of treating diabetes and reducing diabetes-related deaths in obese adults.

Researchers from RTI International and the Centers for Disease Control & Prevention used the CDC's Cost-Effectiveness model to simulate the costs of bariatric surgery compared to continued diabetes treatment in adults with a BMI of 35 or higher.  The research looked at two different groups of people: those who have had diabetes for more than 10 years and those who have been diagnosed with diabetes within the last five years.

Researchers factored in data from recent studies, which show that in many diabetic patients who undergo bariatric surgery, blood sugar levels are stabilized and patients can often discontinue use of diabetic medications. Other risk factors and diabetic complications are also typically reduced, such as vision problems, kidney disease, and nerve damage, resulting in an improved quality of life for obese diabetic patients.

In all simulated situations using adjustable gastric banding or gastric bypass, researchers determined that both methods of bariatric surgery are relatively cost-effective in treating diabetes. Though research indicated that health care costs will increase if more patients undergo bariatric surgery, those increases are far below the estimated costs of continued diabetes care.

The study determined that bariatric surgery increases quality-adjusted life-years (QALY), a measure of the impact of a health condition that assesses the value of a form of medical treatment.  Lap-Band surgery had cost-effectiveness ratios of $11,000 per QALY for patients with newly diagnosed diabetes, and $13,000 per QALY for patients who had diabetes for more than 10 years. Though these numbers may seem high, they are relatively low compared to costs associated with common forms of diabetes treatment. They are also low compared to the $50,000 life-year benchmark, which is considered the reasonable cost of extending a person's life by one year.  According to NYU School of Medicine, $50,000 represents the cost of one year of dialysis treatment.

Thomas Hoerger, Ph.D., lead author of the study and a health economist at RTI International, cautions that no study has directly compared gastric bypass and adjustable gastric banding as a diabetes treatment. Further research is needed to determine which procedure is more effective in resolving the symptoms and complications of diabetes.

References:

Bariatric Surgery is Cost-Effective Treatment for Severely Obese Adults with Diabetes, Study Finds

Cost-Effectiveness of Bariatric Surgery for Severely Obese Adults with Diabetes

$50,000: The Price of a Car or the Price of Life?