Estimated Costs of Clinical and Surgical Treatment of Severe Obesity in the Brazilian Public Health System

• Published in: Obesity surgery 2017-12, Vol.27 (12), p.3273-3280
• Main Authors: Zubiaurre, Paula Rosales, Bahia, Luciana Ribeiro, da Rosa, Michelle Quarti Machado, Assumpção, Roberto Pereira, Padoin, Alexandre Vontobel, Sussembach, Samanta Pereira, da Silva, Everton Nunes, Mottin, Claudio Corá
• Format: Article
• Language: English
• Subjects: Adult; Anti-Obesity Agents - economics; Anti-Obesity Agents - therapeutic use; Bariatric Surgery - economics; Bariatric Surgery - statistics & numerical data; Brazil - epidemiology; Costs and Cost Analysis; Cross-Sectional Studies; Diet Therapy - economics; Diet Therapy - statistics & numerical data; Female; Gastrointestinal surgery; Health Care Costs; Health care expenditures; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity, Morbid - economics; Obesity, Morbid - epidemiology; Obesity, Morbid - therapy; Original Contributions; Public health; Public Health - economics; Surgery; Weight Reduction Programs - economics; Weight Reduction Programs - statistics & numerical data
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-017-2776-5

Background Obesity is a major global epidemic and a burden to society and health systems. This study aimed to estimate and compare the anual costs of clinical and surgical treatment of severe obesity from the perspective of the Brazilian Public Health System. Methods An observational and cross-sectional study was performed in three reference centers. Data collection on health resources utilization and productivity loss was carried out through an online questionnaire. Participants were divided in clinical (waiting list for a bariatric surgery) and surgical groups (open Roux-en-Y gastric bypass), and then allocated by the time of surgery (up to 1 year; 1–2 years; 2–3 years; and >3 years). Costs of visits, medications, exams, and surgeries were obtained from government sources. Data on non-medical costs, such as transportation, special diets, and caregivers, were also colleted. Productivity loss was estimated using self-reported income. Costs in local currency (Real) were converted to international dollars (Int$ 2015). Results Two hundred and seventy-four patients, 140 in surgical group and 134 in clinical group were included. In first postoperative year, the surgical group had higher costs than clinical group (Int$6005.47 [5000.18–8262.36] versus 2148.14 [1412.2–3506.8]; p  = 0.0002); however, from the second year, the costs decreased progressively. In the same way, indirect costs decreased significantly after surgery (259.08 [163.63–662.72] versus 368.17 [163.62–687.27]; p  = 0.06). Conclusion Total costs were higher in the surgical group in the first 2 years after surgery. However, from the third year on, the costs were lower than in the clinical group.