Bariatric Surgery Coverage: a Comprehensive Budget Impact Analysis from a Payer Perspective.

Abstract:

OBJECTIVE:The objective of this study was to estimate a payer's budget impact of bariatric surgery coverage under (1) unrestricted, (2) budget-restricted ($500,000/year), and (3) quantity-restricted (100/year) medical benefit plan scenarios versus non-coverage in general and type 2 diabetes mellitus (T2DM) populations over a 10-year period. METHODS:Using recently published literature and health technology assessment reports, the model evaluated a hypothetical payer population of 100,000 members under current real-world trends: BMI-defined obesity groups (31.3% normal/underweight, 33% overweight, 20.4% obese, 9% severely obese and 6.3% morbidly obese), T2DM prevalence (6.7-27.5%; 100% for the T2DM model), surgery type (LAGB, BPD/DS, VSG, and RYGB), and differential outcomes (T2DM resolution, costs, and reoperation and complications rates). Assuming a surgery election rate of 1.42% among eligible candidates with a 3% discount rate and 10% annual surgery turnover rate, the model calculated the incremental cost per-member-per-month (PMPM) by estimating the difference in total non-T2DM and T2DM-related expected costs and savings. One-way (± 25%) sensitivity analysis was performed. RESULTS:The impact of covering bariatric surgery under multiple scenarios for a general (or T2DM) population ranged from an additional $0.3 to $3.6 (T2DM: $0.3 to $10.5) PMPM in year 1. Incremental costs diminished over time, breaking even between years 5 and 9 (T2DM: 5-6), and by year 10, cost savings were estimated to be between $1.5 and $4.8 (T2DM: $1.2 and $31.8). CONCLUSION:Providing bariatric surgery coverage may have a modest short-term budget impact increase but would lead to long-term net cost savings in a general population model. The cost savings were much more pronounced in the T2DM model.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Palli SR,Rizzo JA,Heidrich N

doi

10.1007/s11695-017-3085-8

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

1711-1723

issue

6

eissn

0960-8923

issn

1708-0428

pii

10.1007/s11695-017-3085-8

journal_volume

28

pub_type

杂志文章
  • Intimate saboteurs.

    abstract:BACKGROUND:The bariatric patient exists in dynamic relationship with family members and friends who have considerable influence upon the patient and his or her surgical outcome. When family members and friends behave as intimate saboteurs, they attempt to hamper, hurt, or subvert the bariatric patient's goal of achievi...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089297765555449

    authors: Andrews G

    更新日期:1997-10-01 00:00:00

  • Psychiatric symptoms among prospective bariatric surgery patients: rates of prevalence and their relation to social desirability, pursuit of surgery, and follow-up attendance.

    abstract:BACKGROUND:There is a very limited empirical literature regarding the psychiatric status of prospective bariatric patients and no studies that examine potential social desirability effects on self-presentation for this patient population. METHODS:The Psychiatric Diagnostic Screening Questionnaire (PDSQ) was utilized t...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/0960892053923815

    authors: Rosik CH

    更新日期:2005-05-01 00:00:00

  • Stapler division of the omentum and small bowel mesentery in morbidly obese patients undergoing gastric bypass surgery.

    abstract:BACKGROUND:Roux-en-Y gastric bypass (RYGB) procedures can be technically demanding because of anatomical factors including fat distribution, organ fixation, and wound depth. We developed a technique using the Multifire Endo GIA 60 2.5 disposable surgical stapler which allows greater mobilization, less blood loss, and d...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089297765555755

    authors: Sapala JA,Wood MH,Sapala MA,Mason DS

    更新日期:1997-06-01 00:00:00

  • A Novel Intragastric Satiety-Inducing Device to Inhibit Weight Gain in Juvenile Pigs: a Pilot Study.

    abstract:BACKGROUND AND AIMS:Minimally invasive therapies for obesity are a bridge between lifestyle interventions and bariatric surgery. We developed a novel device to reduce weight gain rate and evaluated its safety and efficacy in juvenile pigs. METHODS:The intragastric satiety-inducing device (ISD) comprises a self-expanda...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-020-04930-5

    authors: Bakheet N,Na HK,Park JH,Ryu DS,Jeon JY,Khashab MA,Kumbhari V,Tsauo J,Song HY,Hu HT,Kim DH,Jung HY

    更新日期:2020-11-01 00:00:00

  • Psychological Effects of Vertical Banded Gastroplasty on Pathologically Obese Patients.

    abstract::For a period of 2 years the authors have examined on 16 pathologically obese patients the psychological effects of the weight loss resulting from vertical banded gastroplasty. At the time of surgery the patients' average age was 41 years. The patients' average weight of 125.9 kg (range 110-150 kg) decreased after surg...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089292765560114

    authors: La Manna A,Ricci GB,Giorgi I I,Gossemburg M,La Manna L,Catona A

    更新日期:1992-08-01 00:00:00

  • Does Preincisional Infiltration with Bupivacaine Reduce Postoperative Pain in Laparoscopic Bariatric Surgery?

    abstract:BACKGROUND:Current evidence suggests that local anesthetic wound infiltration should be employed as part of multimodal postoperative pain management. There is scarce data concerning the benefits of this anesthetic modality in laparoscopic weight loss surgery. Therefore, we analyzed the influence of trocar site infiltra...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-015-1761-0

    authors: Moncada R,Martinaitis L,Landecho M,Rotellar F,Sanchez-Justicia C,Bellver M,de la Higuera M,Silva C,Osés B,Martín E,Pérez S,Hernandez-Lizoain JL,Frühbeck G,Valentí V

    更新日期:2016-02-01 00:00:00

  • Use of endoluminal antireflux therapies for obese patients with GERD.

    abstract:BACKGROUND:Obese patients with gastroesophageal reflux disease (GERD) refractory to medical therapy are a challenging patient population as obesity is a preoperative predictor of failure after antireflux surgery. We therefore sought to evaluate outcomes using one of two commercially available endoluminal therapies in t...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-008-9715-4

    authors: White B,Jeansonne LO,Cook M,Chavarriaga LF,Goldenberg EA,Davis SS,Smith CD,Khaitan L,Lin E

    更新日期:2009-06-01 00:00:00

  • Bariatric re-operations: are they preventable?

    abstract:BACKGROUND:Many operations are currently used for morbid obesity, and every procedure appears to have advantages, drawbacks and failures. Re-operation is a part of bariatric surgery practice that is necessary in the event of failure. We analyzed the reasons for failure in the bariatric re-operation group. METHODS:From...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089200321593733

    authors: Gawdat K

    更新日期:2000-12-01 00:00:00

  • What becomes of patients one year after the intragastric balloon has been removed?

    abstract:BACKGROUND:The BioEnterics Intragastric Balloon (BIB) is a saline-filled balloon recommended to remain in the gastric cavity for a maximum of 6 months. Is this short period sufficient to change patients' lifestyle and eating practices to maintain weight reduction after BIB removal? METHODS:100 patients who received a ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/0960892054222894

    authors: Herve J,Wahlen CH,Schaeken A,Dallemagne B,Dewandre JM,Markiewicz S,Monami B,Weerts J,Jehaes C

    更新日期:2005-06-01 00:00:00

  • Achalasia-like disorder after laparoscopic adjustable gastric banding: a reversible side effect?

    abstract::Literature data concerning the effect of laparoscopic adjustable gastric banding (LAGB) on esophageal motility are conflicting. Achalasia-like disorder involving the absence of esophageal peristalsis and impaired esophago-gastric junction (EGJ) is probably under-estimated and can result in failure and band removal. Th...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-012-0627-y

    authors: Robert M,Golse N,Espalieu P,Poncet G,Mion F,Roman S,Boulez J,Gouillat C

    更新日期:2012-05-01 00:00:00

  • Revisional Surgery Following Laparoscopic Gastric Plication.

    abstract:BACKGROUND:The laparoscopic gastric plication (LGP) is a relative new bariatric procedure that has gained popularity over the last few years, but no real consensus exists and the evidence is unclear, especially in its real efficacy, safety, and durability. METHODS:Retrospective study analyzing the records patients sub...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-016-2242-9

    authors: Zerrweck C,Rodríguez JG,Aramburo E,Vizcarra R,Rodríguez JL,Solórzano A,Maydón HG,Sepúlveda EM

    更新日期:2017-01-01 00:00:00

  • Outcomes of Sleeve Gastrectomy in Septuagenarians.

    abstract:BACKGROUND:Few previous studies have assessed the safety of bariatric surgery in septuagenarians. METHODS:A retrospective analysis of all patients 70 years or older who underwent laparoscopic sleeve gastrectomy at our institution between 2012 and 2017 was performed. This group was compared to a matched cohort of young...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-018-3418-2

    authors: Al-Kurd A,Grinbaum R,Mordechay-Heyn T,Asli S,Abubeih A,Mizrahi I,Mazeh H,Beglaibter N

    更新日期:2018-12-01 00:00:00

  • Uncommon intragastric migration of the Swedish adjustable gastric band.

    abstract:BACKGROUND:The aim of this study was to assess the incidence of intragastric migration of the Swedish adjustable gastric band (SAGB) and to evaluate the safety and effectiveness of gastroscopic band removal. METHODS:Between January 1996 and December 2001, 454 patients (381 women, 73 men) underwent a laparoscopic SAGB ...

    journal_title:Obesity surgery

    pub_type: 临床试验,杂志文章

    doi:10.1381/096089202321088183

    authors: Mittermair RP,Weiss H,Nehoda H,Aigner F

    更新日期:2002-06-01 00:00:00

  • Determinants of hyperhomocysteinemia after gastric bypass surgery in obese subjects.

    abstract:BACKGROUND:Effectiveness of gastric bypass (GBP) on reduction of vascular risk factors is well established, but GBP induces nutritional deficits that could reduce the cardiovascular benefit of weight loss. Particularly, hyperhomocysteinemia, now clearly identified as a vascular risk factor, has been described after GBP...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-010-0269-x

    authors: Ledoux S,Coupaye M,Bogard C,Clerici C,Msika S

    更新日期:2011-01-01 00:00:00

  • Omega Loop Gastroileal Bypass (OLGIBP/SAGI) Versus One Anastomosis Gastric Bypass (OAGB): Medium-Term Results.

    abstract:INTRODUCTION:In bariatric surgery, new surgical techniques are continually being developed. The one anastomosis gastric bypass (OAGB) has become increasingly common since 2001. However, some patients experience bile reflux or excessive weight loss. This study aimed to assess a new bariatric procedure designed to avoid ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-020-05165-0

    authors: Kassir R,Giudicelli X,Lointier P,Breton C,Blanc P

    更新日期:2021-01-07 00:00:00

  • Comparison of Weight Loss in Sleeve Gastrectomy Patients With and Without Antrectomy: a Prospective Randomized Study.

    abstract:BACKGROUND:Laparoscopic sleeve gastrectomy (LSG) restricts gastric volume to achieve weight loss. We aimed to compare the efficacy of LSG with and without antrectomy for achieving weight loss. METHODS:The prospective randomized study comprised 127 obese patients that underwent either LSG with antrectomy (2 cm to pylor...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-019-04177-9

    authors: Omarov T,Samadov E,Coskun AK,Unlu A

    更新日期:2020-02-01 00:00:00

  • The Effect of Laparoscopic Sleeve Gastrectomy with Concomitant Hiatal Hernia Repair on Gastroesophageal Reflux Disease in the Morbidly Obese.

    abstract:BACKGROUND:The effect of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) is controversial. Although concomitant hiatal hernia repair (HHR) at the time of LSG is common and advocated by many, there are few data on the outcomes of GERD symptoms in these patients. The aim of this study was ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-015-1737-0

    authors: Samakar K,McKenzie TJ,Tavakkoli A,Vernon AH,Robinson MK,Shikora SA

    更新日期:2016-01-01 00:00:00

  • Bio-enteric intragastric balloon in obese patients: a retrospective analysis of King Faisal Specialist Hospital experience.

    abstract:BACKGROUND:Bio-enteric intragastric balloon (BIB) insertion is gaining popularity for weight reduction in obese patients. We evaluated the efficacy, tolerability, and safety of BIB in the treatment of obesity. METHODS:A total of 173 Saudi obese patients [mean+/-SD age 34.5 +/- 11.6 years, 58 (33.5%) were men] who unde...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-008-9654-0

    authors: Al Kahtani K,Khan MQ,Helmy A,Al Ashgar H,Rezeig M,Al Quaiz M,Kagevi I,Al Sofayan M,Al Fadda M

    更新日期:2010-09-01 00:00:00

  • Impact of gastric banding on plasma adiponectin levels.

    abstract:BACKGROUND:Several endocrine abnormalities are reported in obesity. In an earlier study, we found that the changes in BMI following laparoscopic adjustable gastric banding (LAGB) were associated with changes in hormone profiles such as insulin and proinsulin. In the current study, we explored the changes in plasma adip...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089206778026244

    authors: Diker D,Vishne T,Maayan R,Weizman A,Vardi P,Dreznik Z,Seror D,Ram E

    更新日期:2006-08-01 00:00:00

  • Self-Reported Eating Disorder Symptoms Before and After Gastric Bypass and Duodenal Switch for Super Obesity--a 5-Year Follow-Up Study.

    abstract:BACKGROUND:This study assessed eating disorder pathology in persons with obesity before and after Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion with duodenal switch (DS), in a 5-year follow-up study. METHODS:Sixty participants with BMI 50-60 kg/m(2) were randomly assigned to RYGB (n = 31) or DS (n = 29...

    journal_title:Obesity surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s11695-015-1790-8

    authors: Morseth MS,Hanvold SE,Rø Ø,Risstad H,Mala T,Benth JŠ,Engström M,Olbers T,Henjum S

    更新日期:2016-03-01 00:00:00

  • Laparoscopic vertical banded gastroplasty--an effective long-term therapy for morbidly obese patients?

    abstract:BACKGROUND:Vertical banded gastroplasty (VBG) has previously been documented as an effective treatment for morbid obesity. We have described a laparoscopic technique to perform this operation. Follow-up data are now presented. METHODS:A consecutive series of 139 morbidly obese patients were operated on with laparoscop...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/09608920160558669

    authors: Olbers T,Lönroth H,Dalenbäck J,Haglind E,Lundell L

    更新日期:2001-12-01 00:00:00

  • Weight-related quality of life in Spanish obese subjects suitable for bariatric surgery is lower than in their North American counterparts: a case-control study.

    abstract:BACKGROUND:Obesity impairs quality of life, but the perception of the impairment could be different from one country to another. The purpose was to compare weight-related quality of life (QOL) between cohorts from Spain and North America. METHODS:A cross-sectional case-control study was performed between two populatio...

    journal_title:Obesity surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s11695-012-0791-0

    authors: Caixàs A,Lecube A,Morales MJ,Calañas A,Moreiro J,Cordido F,Díaz MJ,Masmiquel L,Moreno B,Vidal J,Goday A,Arrizabalaga JJ,García-Luna PP,Iglesias P,Burguera B,Rubio MA,Monereo S,Group for the Study of Obesity of the Spani

    更新日期:2013-04-01 00:00:00

  • Laparoscopic Revision of Bariatric Surgeries in Two Patients with Severe Resistant Hypocalcemia After Endocrine Cervical Surgery.

    abstract::Severe hypocalcemia complicating cervical endocrine surgery in patients with gastric bypass can constitute a major concern. When usual therapies fail to maintain calcemia within the normal range without secondary adverse events, reversal of the bariatric surgery should be considered. We herein report the outcomes of l...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-019-04132-8

    authors: Zaarour M,Zaharia R,Bretault M,Jublanc C,De Marcellus C,Bouillot JL,Lefebvre H,Oppert JM,Aron-Wisnewsky J,Raffin-Sanson ML

    更新日期:2020-04-01 00:00:00

  • Incidental Jejunal Lesion Necessitating Intraoperative Change of Plan During Bariatric Surgery: a Video Case Report.

    abstract::Incidental gastric and small bowel lesions are commonly encountered during bariatric surgery. Resection of these lesions with negative margins in the same sitting is curative; however, this may necessitate intraoperative change of plan. We present a 44-year-old super obese lady in whom an exophytic jejunal mass was fo...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-020-05162-3

    authors: Kumar A,Baksi A,Yadavalli SD,Aggarwal S

    更新日期:2021-01-19 00:00:00

  • One Anastomosis Gastric Bypass/Minigastric Bypass in Patients with BMI 

    abstract:INTRODUCTION:Obesity in the world has been increasing, and the number of diabetic patients will increase by 114%, and the best treatment results are achieved through surgery. Several techniques have been described; the gastric bypass of an anastomosis (MGB/OAGB) has been gaining popularity for its simplicity and good r...

    journal_title:Obesity surgery

    pub_type: 临床试验,杂志文章

    doi:10.1007/s11695-019-04071-4

    authors: Navarrete Aulestia S,Leyba JL,Navarrete Llopis S,Pulgar V

    更新日期:2019-12-01 00:00:00

  • Vertical banded gastroplasty in the Aegean Region of Turkey.

    abstract:BACKGROUND:Obesity is increasing in Turkey. The first experience with vertical banded gastroplasty (VBG) with regular intermediate-term follow-up in the Aegean Region of Turkey is presented. METHODS:From November 1993 to August 1999, 40 morbidity obese patients underwent VBG. The patients were evaluated on the basis o...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089201321209387

    authors: Haciyanli M,Erkan N,Bora S,Gulay H

    更新日期:2001-08-01 00:00:00

  • Changes in weight bias and perceived employability following weight loss and gain.

    abstract:BACKGROUND:The present weight stigma study examined whether attitudes toward and employability of a normal weight person can change after learning that the person had been obese. METHODS:Participants (N = 154) viewed an image of a normal weight woman and rated their impression of her. Next, participants rated their im...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-014-1522-5

    authors: Carels RA,Rossi J,Borushok J,Taylor MB,Kiefner-Burmeister A,Cross N,Hinman N,Burmeister JM

    更新日期:2015-03-01 00:00:00

  • Spectrum of endoscopic findings and therapy in patients with upper gastrointestinal symptoms after laparoscopic bariatric surgery.

    abstract:BACKGROUND:More should be known about the spectrum of endoscopic abnormalities and treatments in patients with upper gastrointestinal (UGI) symptoms after laparoscopic bariatric surgery. METHODS:Patients referred for endoscopic evaluation of UGI symptoms after laparoscopic bariatric surgery were studied. Clinical mani...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089206778392176

    authors: Yang CS,Lee WJ,Wang HH,Huang SP,Lin JT,Wu MS

    更新日期:2006-09-01 00:00:00

  • Laparoscopic surgery for morbid obesity: 1,001 consecutive bariatric operations performed at The Bariatric Institute, Cleveland Clinic Florida.

    abstract:BACKGROUND:Morbid obesity is an epidemic in America. This series evaluates the safety and efficacy in the first 1,001 laparoscopic bariatric operations performed at The Bariatric Institute, Cleveland Clinic Florida. METHODS:A retrospective review was conducted examining all patients undergoing a primary bariatric proc...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089206775565230

    authors: Rosenthal RJ,Szomstein S,Kennedy CI,Soto FC,Zundel N

    更新日期:2006-02-01 00:00:00

  • A Comprehensive Approach for the Prevention of Nausea and Vomiting Following Sleeve Gastrectomy: a Randomized Controlled Trial.

    abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) following sleeve gastrectomy (SG) is a common occurrence. The effect of specific interventions in PONV prevention within enhanced recovery pathways remains unclear. The aim of this study was to evaluate the impact of a comprehensive approach for the prevention of PONV...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-020-04795-8

    authors: Spaniolas K,Nie L,Moller D,Tatarian T,Hesketh A,Yang J,Docimo S,Bates A,Gan TJ,Pryor A

    更新日期:2020-11-01 00:00:00