Bariatric surgery

The report presents a summary of the reimbursement situation for bariatric surgery. Report includes analysis for placement of adjustable gastric band, sleeve gastrectomy, and gastric bypass. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.

In mid-June 2018, the Spanish Network of Agencies for Assessing National Health System Technologies and Performance (REDETS) has published a report on the efficacy and safety of bariatric surgery in morbidly obese patients.

Article “Cost-effectiveness analysis of bariatric surgery for morbid obesity in Belgium” published in the “Journal of Medical Economics” provides insights about economic outcomes of bariatric surgery in Belgium using Markov modeling. Over the 10-year horizon, bariatric surgery led to a cost increment of €3,788 and 1.4 additional QALY (€2,809/QALY) compared with optimal medical management. Over lifetime horizon, surgery led to 1.1 life years and 5.0 QALY gains and €9,332/patient average cost savings.

Article “Bariatric surgery versus conservative management for morbidly obese patients in Spain: a cost-effectiveness analysis” published in the “Expert Review of Pharmacoeconomics & Outcomes Research” provides insights about economic outcomes of bariatric surgery in Spain using Markov modeling. Over the 10-year horizon, bariatric surgery led to a cost increment of €9,386 and 1.6 additional QALY (€5,966/QALY) compared with optimal medical management. Over lifetime horizon, surgery led to 0.6 life years and 4.4 QALY gains and €300/patient average cost savings.

The article "Patient Characteristics, Procedural and Safety Outcomes of Bariatric Surgery in England: a Retrospective Cohort Study—2006–2012" published in Obesity Surgery reviews the UK experience with bariatric surgery.

Article “Cost-utility analysis of bariatric surgery compared with conventional medical management in Germany: a decision analytic modeling” was published in the BMC Surgery. Surgery was found cost-effective at 10-year time horizon and cost saving over life time of operated cohort. Delay in provision of surgery led to reduction of gained health benefits.

Article “Cost analysis of bariatric surgery in Denmark made with a decision-analytic model” was published in Danish Medical Journal. Surgery was found cost-effective at 10 years and cost saving over life time perspective in comparison with conservative medical management.

New publication in Obesity Facts provides insights into cost-effectiveness of bariatric surgery in Italy ("Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling"). Bariatric surgery was found to be cost effective at 10-year and cost saving at lifetime time horizon.

From 1st of April 2017 bariatric surgery will be fully transferred for commissioning by Clinical Commissioning Groups from national payer, the NHS England. English physicians are concerned that provision of surgery will face restrictions by local payers.