In patients with type 2 diabetes, two types of bariatric surgery for weight loss may be effective for reducing long-term health care costs, a study from Duke University School of Medicine and Kaiser Permanente has found.
The study, published January 27 in the journal Annals of Internal Medicine, found that patients who underwent either Roux-en-Y gastric bypass or sleeve gastrectomy experienced significant decreases in overall health care costs afterward. There were no differences in costs between the two groups of patients except for a transient difference in the first six months post-surgery.
“This was a head-to-head comparison of costs before and after surgery of the two most common procedures for bariatric surgery. The cost reductions were similar for both the procedures, and they were driven by a reduction in medication expenses,” — Matthew L. Maciejewski, PhD
“This was a head-to-head comparison of costs before and after surgery of the two most common procedures for bariatric surgery,” said Matthew L. Maciejewski, PhD, the corresponding author of the study and a professor in the Department of Population Health Sciences at Duke University School of Medicine. He is also a senior research career scientist in the Center of Innovation to Accelerate Discovery and Practice Transformation at the Durham VA Medical Center.
“The cost reductions were similar for both the procedures, and they were driven by a reduction in medication expenses,” he said.
Costs were about $500 higher in the first six months for patients who had Roux-en-Y gastric bypass, driven by a higher inpatient admission rate. But that difference was transient, Maciejewski said.
The retrospective cohort study analyzed health care costs three years before and five and a half years after bariatric surgery. Researchers from Duke and Kaiser Permanente studied data about costs for medications and inpatient and outpatient care from 6,690 patients with type 2 diabetes at Kaiser Permanente Southern California and Kaiser Permanente Washington between January 2012 and December 2019.
For next steps, Maciejewski said the study team plans to examine subgroups of bariatric surgical patients to find out if certain groups have greater potential for cost savings with each type of procedure, and to compare surgical patients to nonsurgical patients.
Other authors of the study from Duke and the Durham VA Medical Center included: Lindsay Zepel, MS; Valerie A. Smith, DrPH; Amy G. Clark, PhD; and Caroline Sloan, MD, MPH.