Cost-effectiveness of gastric bypass for severe obesity

PURPOSE: To estimate the cost-effectiveness of gastric bypass in the treatment of severe obesity. SUBJECTS AND METHODS: We performed a cost-effectiveness analysis of gastric bypass versus no treatment from the payer perspective. We discounted quality-adjusted life-years (QALYs), life-years, and cost during the patient's lifetime. Our target group comprised women and men aged 35 to 55 years with a body mass index between 40 and 50 kg/m(2), and who did not have cardiovascular disease and in whom conservative bariatric therapies had been unsuccessful. RESULTS: The base case cost-effectiveness ratios ranged from $5000 to $16,100 per QALY for women and from $10,000 to $35,600 per QALY for men, depending on age and initial body mass index. In a few subgroups of older, less obese men, variation in parameters such as loss of excess weight, obesity-related quality of life, complication rates, and perioperative mortality affected the cost-effectiveness ratios. Parameter variation did not result in meaningful changes in the remaining patients. CONCLUSION: Gastric bypass is a cost-effective alternative to no treatment, providing substantial lifetime benefits in patients who are severely obese.