PMID- 28722299
OWN - NLM
STAT- MEDLINE
DCOM- 20180206
LR  - 20181202
IS  - 1930-739X (Electronic)
IS  - 1930-7381 (Print)
IS  - 1930-7381 (Linking)
VI  - 25
IP  - 9
DP  - 2017 Sep
TI  - Cost and Health Care Utilization Implications of Bariatric Surgery Versus 
      Intensive Lifestyle and Medical Intervention for Type 2 Diabetes.
PG  - 1499-1508
LID - 10.1002/oby.21927 [doi]
AB  - OBJECTIVE: The aim of this study was to compare the cost and health care 
      utilization of patients with obesity and type 2 diabetes mellitus (T2DM) 
      randomized into either Roux-en-Y gastric bypass (RYGB) surgery or an intensive 
      lifestyle and medical intervention (ILMI). METHODS: This analysis (N = 745) is 
      based on 2-year follow-up of a small randomized controlled trial (RCT); adult 
      patients with obesity and T2DM were recruited between 2011 and 2012 from Kaiser 
      Permanente Washington. Comparisons were made for patients randomized into either 
      RYGB (N = 15) or ILMI (N = 17). RESULTS: There were no significant cost savings 
      for RYGB versus ILMI patients through the follow-up years. Pharmacy cost was 
      lower for RYGB versus ILMI patients by about $900 in year 2 versus year 0; 
      however, inpatient and emergency room costs were higher for surgery patients in 
      follow-up years relative to year 0. Median total cost for nonrandomized patients 
      was higher in year 0 and in year 2 compared to randomized patients. CONCLUSIONS: 
      Bariatric surgery is not cost saving in the short term. Moreover, the costs of 
      patients who enter into RCTs of RYGB may differ from the costs of those who do 
      not enter RCTs, suggesting use of caution when using such data to draw inferences 
      about the general population with obesity.
CI  - (c) 2017 The Obesity Society.
FAU - Banerjee, Souvik
AU  - Banerjee S
AUID- ORCID: 0000-0001-5096-5749
AD  - Department of Medicine, Boston University School of Medicine, Boston, 
      Massachusetts, USA.
FAU - Garrison, Louis P Jr
AU  - Garrison LP Jr
AD  - Department of Pharmacy, University of Washington, Seattle, Washington, USA.
FAU - Flum, David R
AU  - Flum DR
AD  - Departments of Medicine and Surgery, University of Washington, Seattle, 
      Washington, USA.
FAU - Arterburn, David E
AU  - Arterburn DE
AD  - Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA.
LA  - eng
SI  - ClinicalTrials.gov/NCT01295229
GR  - R01 DK089528/DK/NIDDK NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20170719
PL  - United States
TA  - Obesity (Silver Spring)
JT  - Obesity (Silver Spring, Md.)
JID - 101264860
RN  - 0 (Anti-Obesity Agents)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Adult
MH  - Anti-Obesity Agents/economics/therapeutic use
MH  - *Bariatric Surgery/economics
MH  - Diabetes Mellitus, Type 2/complications/*therapy
MH  - Emergency Service, Hospital/economics
MH  - Gastric Bypass
MH  - *Health Care Costs
MH  - Humans
MH  - Hypoglycemic Agents/economics/therapeutic use
MH  - *Life Style
MH  - Male
MH  - Middle Aged
MH  - Obesity/complications/surgery/*therapy
MH  - Patient Acceptance of Health Care
MH  - Treatment Outcome
MH  - Washington
PMC - PMC5769931
MID - NIHMS929851
COIS- The authors have no non-financial interests that may be relevant to the submitted 
      work.
EDAT- 2017/07/20 06:00
MHDA- 2018/02/07 06:00
PMCR- 2018/09/01
CRDT- 2017/07/20 06:00
PHST- 2017/01/13 00:00 [received]
PHST- 2017/06/06 00:00 [revised]
PHST- 2017/06/07 00:00 [accepted]
PHST- 2017/07/20 06:00 [pubmed]
PHST- 2018/02/07 06:00 [medline]
PHST- 2017/07/20 06:00 [entrez]
PHST- 2018/09/01 00:00 [pmc-release]
AID - 10.1002/oby.21927 [doi]
PST - ppublish
SO  - Obesity (Silver Spring). 2017 Sep;25(9):1499-1508. doi: 10.1002/oby.21927. Epub 
      2017 Jul 19.