Abstract

BACKGROUND: Bariatric surgery is an effective and enduring treatment for severe obesity. In addition to improvements in health status, bariatric surgery has been noted to potentially decrease post-operative health care costs particularly medication utilization.STUDY DESIGN: Longitudinal analysis of 2007-2012 claims data comparing a bariatric surgery cohort with a propensity matched non-surgical control group over a total five-year time period. Truven Health Analytics MarketScan Commercial Claims and Encounters Database with a total enrollment of 56 million covered lives from all insurers and representing all 50 states was employed. An initial sample of 384,343 obese patients were identified with a total of 5,978 matched 1:1 pairs of obese bariatric surgery cases and controls without bariatric surgery being designated following matching and propensity score matching procedure. 2,700 of those matched pairs had at least 4 years of follow-up following index date.RESULTS: The matched cohorts included 2,700 patients (77.2% female; mean age 47.1 years). During the 4-year follow-up period, bariatric surgery patients had 22.6% lower pharmacy costs compared to non-surgical controls (p<0.001). Mean total pharmacy costs showed a sustained decrease in the surgery group compared to the matched controls ($8,411 vs. $9,900; p<0.001). Medication utilization in the surgery group declined significantly from 1-year pre-operative to 4-years post-operative in contrast to the control group. In the 4-year post-surgery period, the number of anti-diabetic, antihypertensive and cardiac prescriptions in the surgical cases reduced by 73.7%, 48.3%, and 48.9%, respectively compared to the controls.CONCLUSIONS: Total pharmacy utilization and costs showed a significant and sustained reduction over 4-year follow-up period among patients undergoing gastric bypass or band surgery in comparison to a propensity-matched control group.

View details for DOI 10.1016/j.jamcollsurg.2018.10.021

View details for PubMedID 30453056