PMID- 31930144
OWN - NLM
STAT- MEDLINE
DCOM- 20200622
LR  - 20220412
IS  - 2314-6753 (Electronic)
IS  - 2314-6745 (Print)
VI  - 2019
DP  - 2019
TI  - Cost-Effectiveness of Bariatric Surgery versus Medication Therapy for Obese 
      Patients with Type 2 Diabetes in China: A Markov Analysis.
PG  - 1341963
LID - 10.1155/2019/1341963 [doi]
LID - 1341963
AB  - AIMS/INTRODUCTION: The present study estimated the cost-effectiveness of 
      bariatric surgery versus medication therapy for the management of recently 
      diagnosed type 2 diabetes mellitus (T2DM) in obese patients from a Chinese health 
      insurance payer perspective. MATERIALS AND METHODS: A Markov model was 
      established to compare the 40-year time costs and quality-adjusted life-years 
      (QALYs) between bariatric surgery and medication therapy. The health-care costs 
      in the bariatric surgery group, proportion of patients in each group with 
      remission of diabetes, and state transition probabilities were calculated based 
      on observed resource utilization from the hospital information system (HIS). The 
      corresponding costs in the medication therapy group were derived from the medical 
      insurance database. QALYs were estimated from previous literature. Costs and 
      outcomes were discounted 5% annually. RESULTS: In the base case analysis, 
      bariatric surgery was more effective and less costly than medication therapy. 
      Over a 40-year time horizon, the mean discounted costs were 86,366.55 RMB per 
      surgical therapy patient and 113,235.94 CNY per medication therapy patient. The 
      surgical and medication therapy patients lived 13.46 and 10.95 discounted QALYs, 
      respectively. Bariatric surgery was associated with a mean health-care savings of 
      26,869.39 CNY and 2.51 additional QALYs per patient compared to medication 
      therapy. Uncertainty around the parameter values was tested comprehensively in 
      sensitivity analyses, and the results were robust. CONCLUSIONS: Bariatric surgery 
      is a dominant intervention over a 40-year time horizon, which leads to 
      significant cost savings to the health insurance payer and increases in health 
      benefits for the management of recently diagnosed T2DM in obese patients in 
      China.
CI  - Copyright (c) 2019 Bin Wan et al.
FAU - Wan, Bin
AU  - Wan B
AD  - Department of Health Insurance Management, The First Affiliated Hospital with 
      Nanjing Medical University, Nanjing, Jiangsu, China.
FAU - Fang, Nan
AU  - Fang N
AUID- ORCID: 0000-0003-1006-6954
AD  - Department of Health Policy, School of Health Policy and Management, Nanjing 
      Medical University, Nanjing, Jiangsu, China.
FAU - Guan, Wei
AU  - Guan W
AD  - Department of General Surgery, The First Affiliated Hospital with Nanjing Medical 
      University, Nanjing, Jiangsu, China.
FAU - Ding, Haixia
AU  - Ding H
AD  - Department of Health Insurance Management, The First Affiliated Hospital with 
      Nanjing Medical University, Nanjing, Jiangsu, China.
FAU - Wang, Ying
AU  - Wang Y
AD  - Department of Health Policy, School of Health Policy and Management, Nanjing 
      Medical University, Nanjing, Jiangsu, China.
FAU - Ge, Xin
AU  - Ge X
AUID- ORCID: 0000-0002-3530-638X
AD  - Department of Health Policy, School of Health Policy and Management, Nanjing 
      Medical University, Nanjing, Jiangsu, China.
FAU - Liang, Hui
AU  - Liang H
AD  - Department of General Surgery, The First Affiliated Hospital with Nanjing Medical 
      University, Nanjing, Jiangsu, China.
FAU - Li, Xin
AU  - Li X
AUID- ORCID: 0000-0003-3951-8061
AD  - Department of Health Policy, School of Health Policy and Management, Nanjing 
      Medical University, Nanjing, Jiangsu, China.
AD  - Department of Clinical Pharmacy, School of Pharmacy, Nanjing Medical University, 
      Nanjing, Jiangsu, China.
AD  - Center for Global Health, School of Public Health, Nanjing Medical University, 
      Nanjing, Jiangsu, China.
FAU - Zhan, Yiyang
AU  - Zhan Y
AUID- ORCID: 0000-0003-1297-3718
AD  - The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 
      China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20191219
PL  - England
TA  - J Diabetes Res
JT  - Journal of diabetes research
JID - 101605237
SB  - IM
MH  - Adult
MH  - *Bariatric Surgery/economics
MH  - Cost-Benefit Analysis
MH  - Diabetes Mellitus, Type 2/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - *Markov Chains
MH  - Middle Aged
MH  - Obesity/complications/*therapy
MH  - Quality-Adjusted Life Years
MH  - Retrospective Studies
PMC - PMC6939432
COIS- The authors declare no conflicts of interest.
EDAT- 2020/01/14 06:00
MHDA- 2020/06/23 06:00
PMCR- 2019/12/19
CRDT- 2020/01/14 06:00
PHST- 2019/06/26 00:00 [received]
PHST- 2019/10/07 00:00 [revised]
PHST- 2019/11/26 00:00 [accepted]
PHST- 2020/01/14 06:00 [entrez]
PHST- 2020/01/14 06:00 [pubmed]
PHST- 2020/06/23 06:00 [medline]
PHST- 2019/12/19 00:00 [pmc-release]
AID - 10.1155/2019/1341963 [doi]
PST - epublish
SO  - J Diabetes Res. 2019 Dec 19;2019:1341963. doi: 10.1155/2019/1341963. eCollection 
      2019.