Incremental Net Monetary Benefit of Bariatric Surgery: Systematic Review and Meta-Analysis of Cost-Effectiveness Evidences

Abstract

This systematic review aimed to comprehensively synthesize cost-effectiveness evidences of bariatric surgery by pooling incremental net monetary benefits (INB). Twenty-eight full economic evaluation studies comparing bariatric surgery with usual care were identified from five databases. In high-income countries (HICs), bariatric surgery was cost-effective among mixed obesity group (i.e., obesity with/without diabetes) over a 10-year time horizon (pooled INB = $53,063.69; 95% CI $42,647.96, $63,479.43) and lifetime horizon (pooled INB = $101,897.96; 95% CI $79,390.93, $124,404.99). All studies conducted among obese with diabetes reported that bariatric surgery was cost-effective. Also, the pooled INB for obesity with diabetes group over lifetime horizon in HICs was $80,826.28 (95% CI $32,500.75, $129,151.81). Nevertheless, no evidence is available in low- and middle-income countries.

Keywords: Bariatric surgery; Cost-effectiveness; Economic evaluation; Incremental net monetary benefit.

Fig. 1

Flow diagram of the included studies

Fig. 2

Pooled INBs of bariatric surgery among mixed obesity group in high income countries over lifetime horizon

Fig. 3

Pooled INBs of bariatric surgery among mixed obesity group in high income countries over 10-year time horizon

Fig. 4

Pooled INBs of bariatric surgery among obesity with diabetes group in high income countries over life-time horizon