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Cost-utility analysis of different bariatric surgeries in Hungary

Angol absztrakt:

Background: Obesity has become a major health issue in Hungary during the last 30 years. Two-thirds of the population is considered overweight or obese, and lifestyle-related chronic diseases and mortality data are amongst the worst in Europe. Recently published economic evaluations of bariatric surgical interventions suggests that these interventions are not only cost-effective compared with conservative therapy, but they generate lower costs and better health outcomes. Aim: The aim of this study was to; outline the cost structure of bariatric surgeries in Hungary; to propose a potential reimbursement for social security, and to evaluate the cost-utility of laparoscopic Roux-en-Y gastric bypass (LRGB) and laparoscopic gastric sleeve resection (LGSR) compared with conservative treatment. Methods: Analysis was conducted from a healthcare provider perspective, using a Markov model with a time horizon of 10 years and a discount rate of 3.7% (costs and health). QALY data were derived from literature fo - cusing on relevant European populations. Other parameters were based on national publications and registries, supplemented where needed by European data. Results: The mean costs were HUF 3,240,316 (€10,479) and HUF 5,453,095 (€17,635), and the mean incremental QALYs 5.35 and 3.28 for bariatric surgery and conservative treatment, respectively. Bariatric surgery was both more effective and less costly than conservative treatment from the 4th year of the model, and was thus de - monstrated as the dominant strategy. Conclusions: In the right patient population, bariatric surgery results in both better health outcomes and lower costs than conservative treatment in Hungary. Due to the high prevalence of obesity and related diseases, the reimbursement of laparoscopic Roux-en-Y gastric by - pass and laparoscopic gastric sleeve resection would generate significant savings for the National Health Insurance Fund and increase the quality of life for patients.

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