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Bariatric surgery doesn’t cut health care costs

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Weight-loss surgery isn’t cost-saving

"Bariatric surgery has dramatic short-term results, but on a population level its outcomes are far less impressive," said Dr. Edward H. Livingston.

The study by Weiner et al. adds to "the accumulating evidence" that weight-loss surgery carries no particular economic benefit. "Coupled with findings that bariatric surgery confers little to no long-term survival benefit, these observations show that bariatric surgery does not provide an overall societal benefit," he noted.

"In other words, the indications for bariatric surgery should be viewed in terms of individual patient benefit without anticipating that there will be cost savings to a health care system offering this treatment," Dr. Livingston said.

Dr. Edward H. Livingston is with the JAMA Network in Chicago. He is deputy editor of JAMA. These remarks were taken from his Invited Critique accompanying Dr. Weiner’s report (JAMA Surg. 2013;148:561).


 

FROM JAMA SURGERY

This lack of cost savings shouldn’t be surprising, given that Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are invasive procedures that carry high early complication rates. It is possible that newer procedures such as sleeve gastrectomy might eventually yield cost savings because of relatively low complication rates, but these operations haven’t yet undergone long-term economic evaluation, they added.

This study was supported in part by Ethicon Endo-Surgery (a division of Johnson & Johnson), Pfizer, and GlaxoSmithKline, as well as by the National BlueCross BlueShield Association and the seven local plans that participated. No other financial conflicts of interest were reported.

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