Bariatric surgery more cost-effective than medical treatment among mildly obese diabetics

Bariatric surgery (BS) is clinically and economically superior to medical treatment (MT) for mild obesity among patients with type 2 diabetes mellitus (T2DM), a new Japan study has found.

Researchers conducted a retrospective analysis of real-world data from 238 eligible patients who received MT for their obesity and from 78 who underwent BS. The primary study objective was to compare between-group rates of 1-year remission, defined by glycated haemoglobin (HbA1c <6.5 percent), including considerations for medical and drug treatment costs.

After propensity-score matching, 46 patients in the BS group achieved remission after 1 year, as opposed to only one in the MT arm, with corresponding rates of 59.0 percent and 0.4 percent (p<0.0001).

Baseline HbA1c was 7.9±1.1 percent in BS patients, which dropped to 6.3±1.0 percent after 1 year. In the MT group, HbA1c hardly changed from 7.9±1.4 percent at baseline to 7.9±1.5 percent after 1 year.

In terms of cost, patients in the BS group were spending a median of USD 70.6, 2.0, and 14.3 monthly on antidiabetic drugs, antihypertensive drugs, and lipid-lowering drugs, respectively, before the intervention. At 1-year postindex, expenditure for all types of medications dropped to USD 0. In the MT group, preintervention monthly costs for the respective treatments were USD 40.9, 2.8, and 1.9, which remained mostly unchanged after 1 year, except for lipid-lowering drugs, whose costs dropped to USD 0.

“Medical costs in this study were limited to the drugs prescribed, which represent a fraction of the total treatment cost of diabetes. A comparison with a broader perspective is needed to investigate the holistic economic impact,” said researchers.