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Wednesday, March 13, 2013

Bariatric surgery may not reduce long-term medical costs.


The Los Angeles Times (2/21, Healy, 692K) reports, "In the span of 15 years, the number of bariatric surgeries performed in the United States has grown more than 16-fold to roughly 220,000 per year, gaining cachet as a near-panacea for obesity." And, "despite the daunting price tag, mounting research has boosted hopes that the stomach-stapling operations could reduce the nation's healthcare bill by weaning patients off the costly drugs and frequent doctor visits that come with chronic obesity-related diseases like diabetes and arthritis. " Now, however, a study published online Feb. 20 in JAMA Surgery "has found that the surgery does not reduce patients' medical costs over the six years after they are wheeled out of the operating room."
        Bloomberg News (2/21, Cortez) reports, "Researchers tracked insurance claims of 29,820 patients for as many as six years after bariatric surgery, comparing their costs with a group of people with obesity-related conditions who didn't have the procedures."
        HealthDay (2/21) reports that investigators "found that two and three years after weight-loss surgery, the total medical costs of those who had the procedure were greater than the total costs of the group that did not have the surgery. Four years after surgery, however, the researchers noted the medical costs of both groups were similar. They pointed out, however, that the weight-loss-surgery group had lower expenditures associated with prescriptions and office visits, but higher inpatient costs."
        According to MedPage Today (2/21), "In a critique of the study, JAMA deputy editor Edward H. Livingston, MD, said bariatric surgery clearly benefits a subgroup of patients who have a complication or condition known to improve dramatically with weight loss, such as diabetes and osteoarthritis. Reducing body mass index should not be the exclusive indication for the surgery." Livingston wrote, "In this era of tight finances and inevitable rationing of healthcare resources, bariatric surgery should be viewed as an expensive resource that can help some patients."
        Heartwire (2/21, Tucker) reports, "On the other hand, Dr Robin Blackstone (Scottsdale Healthcare Bariatric Center, AZ), immediate past president of the American Society for Metabolic and Bariatric Surgery, said in an interview, 'Obese patients routinely experience remission of their major medical problems, get off medications that have serious side effects, and increase their productivity at work. ... One can argue about the validity of this particular paper, but the essential value of the human experience of life after bariatric surgery cannot perhaps be measured by claims data.'" Reuters (2/21, Pittman) also covers the story.

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