Actual Medical and Pharmacy Costs for Bariatric Surgery
Actual Medical and Pharmacy Costs for Bariatric Surgery
The total surgical cost was $25,000 per procedure. One death occurred 1 week after WLS, leaving 39 patients in this group. A majority of the remaining 39 WLS patients reported no major complications. Reported complications included a postoperative infection and intestinal perforation event.
WLS patients were predominantly women (90%) and white (77%); eight were African American and one was Hispanic. Their average age was 50 ± 8 years, and 79% reported having at least some college coursework, with some having postgraduate education. Of the 951 individuals in the non-WLS group, 85% were women and the average age was 49 ± 1 years. Additional data on the 951 control participants were not available due to the absence of follow-up contact for many of these participants.
Mean presurgical weight for the WLS patients was 134.0 ± 18.9 kg. At 4 years postsurgery, the average physician reported weight was 90.2 ± 17.9 kg, indicating that WLS patients lost 62.0% ± 15.9% of excess body weight (excess weight loss). See Myers et al for further information on medical and psychosocial outcomes of surgery.
Table 1 displays total nonpharmaceutical medical claim costs for all years examined in the WLS and non-WLS groups. Total nonpharmaceutical medical costs were greater for the surgical group at postsurgical YR-1, the year that included the $25,000 cost of the surgery; however, costs for the WLS group were lower than the non-WLS group in postsurgical YR-4, YR-5, and YR-6 (Fig. 2).
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Figure 2.
Nonpharmacy medical care costs.
Table 1 also shows costs data by specific medical subcategories. Sleep facility costs were significantly lower in the WLS group compared with the non-WLS group in postsurgical YR-2 and YR-6. "Remaining" medical services had significantly lower costs for the WLS group in postsurgical YR-4, YR-5, and YR-6. Presurgical cost differences were also found, with the non-WLS group having higher costs for physical and occupational therapy in presurgical YR-1 and for laboratory/pathology in presurgical YR-2.
Total pharmacy costs and pharmacy subcategory costs are presented in Table 2. Total pharmacy costs were significantly lower in postsurgery YR-2 and YR-3 for WLS patients, but were not significantly different in remaining postsurgical years (Fig. 3). Costs for antidiabetic agents, antihypertensive agents, and dyslipidemic agents were significantly lower for WLS patients than for non-WLS patients beginning in postsurgical YR-1 and lasting through postsurgical YR-6. Other pharmacy classifications did not differ between WLS and non-WLS patients at any time point examined.
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Figure 3.
Pharmacy costs.
Combined pharmacy and nonpharmacy medical care costs across the 8 years of study were examined (Fig. 4). Total costs were significantly greater for the WLS group in postsurgical YR-1 (P < 0.0001). The WLS group had significantly lower combined costs in postsurgical YR-4 (P = 0.04), YR-5 (P = 0.05), and YR-6 (P < 0.0001). Combining total costs across the 8 years of study, the total medical costs for the non-WLS group were $73,212. The WLS group's total medical care costs were $77,894, which included the $25,000 cost of the surgery.
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Figure 4.
Combined (pharmacy and nonpharmacy medical care) healthcare costs in 8-year study period.
Results
The total surgical cost was $25,000 per procedure. One death occurred 1 week after WLS, leaving 39 patients in this group. A majority of the remaining 39 WLS patients reported no major complications. Reported complications included a postoperative infection and intestinal perforation event.
Demographics
WLS patients were predominantly women (90%) and white (77%); eight were African American and one was Hispanic. Their average age was 50 ± 8 years, and 79% reported having at least some college coursework, with some having postgraduate education. Of the 951 individuals in the non-WLS group, 85% were women and the average age was 49 ± 1 years. Additional data on the 951 control participants were not available due to the absence of follow-up contact for many of these participants.
4-Year Surgical Outcomes
Mean presurgical weight for the WLS patients was 134.0 ± 18.9 kg. At 4 years postsurgery, the average physician reported weight was 90.2 ± 17.9 kg, indicating that WLS patients lost 62.0% ± 15.9% of excess body weight (excess weight loss). See Myers et al for further information on medical and psychosocial outcomes of surgery.
Medical Claims Costs
Table 1 displays total nonpharmaceutical medical claim costs for all years examined in the WLS and non-WLS groups. Total nonpharmaceutical medical costs were greater for the surgical group at postsurgical YR-1, the year that included the $25,000 cost of the surgery; however, costs for the WLS group were lower than the non-WLS group in postsurgical YR-4, YR-5, and YR-6 (Fig. 2).
(Enlarge Image)
Figure 2.
Nonpharmacy medical care costs.
Table 1 also shows costs data by specific medical subcategories. Sleep facility costs were significantly lower in the WLS group compared with the non-WLS group in postsurgical YR-2 and YR-6. "Remaining" medical services had significantly lower costs for the WLS group in postsurgical YR-4, YR-5, and YR-6. Presurgical cost differences were also found, with the non-WLS group having higher costs for physical and occupational therapy in presurgical YR-1 and for laboratory/pathology in presurgical YR-2.
Pharmacy Claims Costs
Total pharmacy costs and pharmacy subcategory costs are presented in Table 2. Total pharmacy costs were significantly lower in postsurgery YR-2 and YR-3 for WLS patients, but were not significantly different in remaining postsurgical years (Fig. 3). Costs for antidiabetic agents, antihypertensive agents, and dyslipidemic agents were significantly lower for WLS patients than for non-WLS patients beginning in postsurgical YR-1 and lasting through postsurgical YR-6. Other pharmacy classifications did not differ between WLS and non-WLS patients at any time point examined.
(Enlarge Image)
Figure 3.
Pharmacy costs.
Combined Medical and Pharmacy Claims Costs
Combined pharmacy and nonpharmacy medical care costs across the 8 years of study were examined (Fig. 4). Total costs were significantly greater for the WLS group in postsurgical YR-1 (P < 0.0001). The WLS group had significantly lower combined costs in postsurgical YR-4 (P = 0.04), YR-5 (P = 0.05), and YR-6 (P < 0.0001). Combining total costs across the 8 years of study, the total medical costs for the non-WLS group were $73,212. The WLS group's total medical care costs were $77,894, which included the $25,000 cost of the surgery.
(Enlarge Image)
Figure 4.
Combined (pharmacy and nonpharmacy medical care) healthcare costs in 8-year study period.
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