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首页> 外文期刊>Obesity surgery >Cost-Utility of Gastric Bypass Surgery Compared to Clinical Treatment for Severely Obese With and Without Diabetes in the Perspective of the Brazilian Public Health System
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Cost-Utility of Gastric Bypass Surgery Compared to Clinical Treatment for Severely Obese With and Without Diabetes in the Perspective of the Brazilian Public Health System

机译：胃旁路手术的成本效用与巴西公共卫生系统的角度严重肥胖的临床治疗与糖尿病的临床治疗

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PurposeObesity is associated with increased morbidity and mortality. Weight loss due to gastric bypass (GBP) surgery improves clinical outcomes and may be a cost-effective intervention. To estimate the cost-effectiveness of GBP compared to clinical treatment in severely obese individuals with and without diabetes in the perspective of the Brazilian public health system.Materials and MethodsA Markov model was developed to compare costs and outcomes of gastric bypass in an open approach to clinical treatment. Health states were living with diabetes, remission of diabetes, non-fatal and fatal myocardial infarction, and death. We also included the occurrence of complications related to surgery and plastic surgery after the gastric bypass surgery. The direct costs were obtained from primary data collection performed in three public reference centers for obesity treatment. Utility values also derived from this cohort, while transition probabilities came from the international literature. A sensitivity analysis was performed to evaluate uncertainties. The model considered a 10-year time horizon and a 5% discount rate.ResultsOver 10 years, GBP increased quality-adjusted life years (QALY) and costs compared to clinical treatment, resulting in an incremental cost-effectiveness ratio (ICER) of Int$1820.17/QALY and Int$1937.73/QALY in individuals with and without diabetes, respectively. Sensitivity analysis showed that utility values and direct costs of treatments were the parameters that affected the most the ICERs.ConclusionThe study demonstrated that GBP is a cost-effective intervention for severely obese individuals in the Brazilian public health system perspective, with a better result in individuals with diabetes.
机译：缺点与发病率和死亡率增加有关。由于胃旁路（GBP）手术引起的体重减轻改善了临床结果，可能是一种经济效益的干预。在巴西公共卫生系统的角度下，估计GBP的成本效益与患有糖尿病的严重肥胖的临床治疗。制定了Markov模型的材料和方法，以比较胃旁路以开放方法的成本和结果临床治疗。健康国家与糖尿病一起生活，缓解糖尿病，非致命和致命的心肌梗死和死亡。我们还包括胃旁路手术后与手术和整形手术相关的并发症。直接成本是从三个公共参考中心进行的主要数据收集获得肥胖治疗。效用价值也来自于此队列，而过渡概率来自国际文献。进行敏感性分析以评估不确定性。该模型被认为是10年的地平线和5％的折扣率。再生10年，GBP增加了质量调整的终身年份（QALY）和成本与临床治疗相比，导致int的增量成本效益率（ICER）增加$ 1820.17 / qaly和int 1937.73 / qaly分别有和没有糖尿病的个体。敏感性分析表明，效用价值和治疗的直接成本是影响最多的转换器的参数。结论该研究表明，英镑为巴西公共卫生系统角度严重肥胖的个人进行了成本效益的干预，具有更好的个人效果患有糖尿病。

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