Bariatric surgery with sleeve gastrectomy and gastric bypass both substantially lower health care expenses for patients with diabetes

Bariatric surgery with sleeve gastrectomy and gastric bypass both substantially lower health care expenses for patients with diabetes  

Total expense reductions driven by medication expenses that decreased by more than 50% in the 5 years post surgery  

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-00480  

URL goes live when the embargo lifts           

A retrospective cohort study compared health expenditures three years before and five and a half years after bariatric surgery in patients with diabetes. The study found that overall expenses decreased significantly in the postsurgical period, with no differences in patients undergoing Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) except in the first six months post-surgery. The study is published in Annals of Internal Medicine.   

Researchers from Duke University and Kaiser Permanente studied data from 6,690 patients with type 2 diabetes (T2D) and a BMI of 35 kg/m2 or greater who had undergone RYGB (n=3,175) or SG (3,515) at Kaiser Permanente Southern California and Kaiser Permanente Washington between January 2012 and December 2019. The researchers examined inpatient, outpatient and medication expenditures three years before surgery and up to five-and-a-half years after surgery between both patient cohorts. They found that average total expenses did not meaningfully differ between the RYGB and SG groups during the three-year presurgical period through the five-and-a-half-year post-surgical period. During the first six months after surgery, total expenditures were higher in the RYGB group than in the SG group but decreased in the next 5 years by a similar amount in both groups. Outpatient expenses in the three years before surgery were around $4,000 for both groups and were around $1,900 six months before surgery were for both groups and decreased to about $800 per 6-month period in the two years after surgery and to about $600 per six-month period three to five-and-a-half-years after surgery for RYGB and around $550 for SG five-and-a-half-years after surgery. Total expenditure decreases were driven by the reduction in medication expenses, which decreased by more than 50% in the five-and-a-half-year postsurgical period to about $1,000 per 6-month period for both RYGB and SG. The results suggest that both RYGB and SG are effective for reducing long-term health care costs for patients with T2D and the cost reductions were similar.  

Media contacts: For an embargoed PDF, please contact Angela Collom at [email protected]. To speak with corresponding author Matthew L. Maciejewski, PhD, please call or email Sarah Avery at 919-724-5343 or [email protected].