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Cited by 163Bariatric Surgery and OutcomesHealth Systems, Economic Evaluations, Quality of LifeObesity, Physical Activity, Diet

Cost-Effectiveness of Bariatric Surgery for Severely Obese Adults With Diabetes

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Hoerger, Thomas J., Zhang, Ping, Segel, Joel E., Kahn, Henry S., Barker, Lawrence E., Couper, Steven·2010·Diabetes Care
DOI 10.2337/dc10-0554PMC PMC2928336
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Abstract

OBJECTIVE: To analyze the cost-effectiveness of bariatric surgery in severely obese (BMI ≥35 kg/m2) adults who have diabetes, using a validated diabetes cost-effectiveness model. RESEARCH DESIGN AND METHODS: We expanded the Centers for Disease Control and Prevention–RTI Diabetes Cost-Effectiveness Model to incorporate bariatric surgery. In this simulation model, bariatric surgery may lead to diabetes remission and reductions in other risk factors, which then lead to fewer diabetes complications and increased quality of life (QoL). Surgery is also associated with perioperative mortality and subsequent complications, and patients in remission may relapse to diabetes. We separately estimate the costs, quality-adjusted life-years (QALYs), and cost-effectiveness of gastric bypass surgery relative to usual diabetes care and of gastric banding surgery relative to usual diabetes care. We examine the cost-effectiveness of each type of surgery for severely obese individuals who are newly diagnosed with diabetes and for severely obese individuals with established diabetes. RESULTS: In all analyses, bariatric surgery increased QALYs and increased costs. Bypass surgery had cost-effectiveness ratios of $7,000/QALY and $12,000/QALY for severely obese patients with newly diagnosed and established diabetes, respectively. Banding surgery had cost-effectiveness ratios of $11,000/QALY and $13,000/QALY for the respective groups. In sensitivity analyses, the cost-effectiveness ratios were most affected by assumptions about the direct gain in QoL from BMI loss following surgery. CONCLUSIONS: Our analysis indicates that gastric bypass and gastric banding are cost-effective methods of reducing mortality and diabetes complications in severely obese adults with diabetes.

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  • ICER estimates for bariatric surgery range from $5,000 to $35,600/QALY.

    “ICER estimates range from $5,000 to $35,600/QALY [176], with durable benefits including 25–35% weight loss, T2D remission, and lower cardiovascular and mortality risk [177].”

    From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [176]

    The Results > One-way sensitivity analyses section reports an estimate of $5,000/QALY for bypass surgery in newly diagnosed diabetic patients aged 35–44. Our copy does not report a $35,600/QALY estimate; the main analyses report $7,000–$13,000/QALY, so the claimed upper endpoint is unsupported. (LLM, conf=0.88)

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Research works printed but not linked: 19

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Authors
Hoerger, T. J., Zhang, P., Segel, J. E., Kahn, H. S., Barker, L. E., & Couper, S.
Affiliations
  • RTI International (US)
  • Centers for Disease Control and Prevention (US)
  • University of Michigan (US)
Corresponding author
Hoerger, Thomas J.
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2010-09-01
Volume
33
Issue
9
Pages
1933-1939
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc10-0554
PMC
PMC2928336
OpenAlex
W2077984932
Cited by
163
References
5
Citations by year
2026: 4 · 2025: 8 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 8 · 2020: 16 · 2019: 12 · 2018: 13 · 2017: 13 · 2016: 15 · 2015: 14 · 2014: 6 · 2013: 10 · 2012: 8
FWCI
13.85
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • RTI International
  • Centers for Disease Control and Prevention
  • U.S. Public Health Service (200-2008-F-26817)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
bariatric surgery, morbid obesity, type 2 diabetes, cost-effectiveness, gastric bypass, gastric banding, diabetes remission, diabetes complications, quality-adjusted life years, quality of life, newly diagnosed diabetes
MeSH terms
Adult, Aged, Aged, 80 and over, Cost-Benefit Analysis, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Obesity, Quality-Adjusted Life Years, Bariatric Surgery

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