The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.

<h4>Background</h4>To examine the cost-effectiveness of providing laparoscopic adjustable gastric banding (LAGB) surgery to all morbidly obese adults in the 2003 Australian population.<h4>Methods and findings</h4>Analyzed costs and benefits associated with two intervention sc...

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Autores principales:	Yong Yi Lee, J Lennert Veerman, Jan J Barendregt
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/27aed08dcc6046d38553367b7c9ef176
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spelling	oai:doaj.org-article:27aed08dcc6046d38553367b7c9ef1762021-11-18T07:44:29ZThe cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.1932-620310.1371/journal.pone.0064965https://doaj.org/article/27aed08dcc6046d38553367b7c9ef1762013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23717680/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>To examine the cost-effectiveness of providing laparoscopic adjustable gastric banding (LAGB) surgery to all morbidly obese adults in the 2003 Australian population.<h4>Methods and findings</h4>Analyzed costs and benefits associated with two intervention scenarios, one providing LAGB surgery to individuals with BMI >40 and another to individuals with BMI >35, with each compared relative to a 'do nothing' scenario. A multi-state, multiple cohort Markov model was used to determine the cost-effectiveness of LAGB surgery over the lifetime of each cohort. All costs and health outcomes were assessed from an Australian health sector perspective and were discounted using a 3% annual rate. Uncertainty and sensitivity analyzes were conducted to test the robustness of model outcomes. Incremental cost-effectiveness ratios (ICERs) were measured in 2003 Australian dollars per disability adjusted life year (DALY) averted. The ICER for the scenario providing LAGB surgery to all individuals with a BMI >40 was dominant [95% CI: dominant -$588] meaning that the intervention led to both improved health and cost savings. The ICER when providing surgery to those with a BMI >35 was $2,154/DALY averted [95% CI: dominant -$6,033]. Results were highly sensitive to changes in the likelihood of long-term complications.<h4>Conclusion</h4>LAGB surgery is highly cost-effective when compared to the $50,000/DALY threshold for cost-effectiveness used in Australia. LAGB surgery also ranks highly in terms of cost-effectiveness when compared to other population-level interventions for weight loss in Australia. The results of this study are in line with other economic evaluations on LAGB surgery. This study recommends that the Australian federal government provide a full subsidy for LAGB surgery to morbidly obese Australians with a BMI >40.Yong Yi LeeJ Lennert VeermanJan J BarendregtPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 5, p e64965 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yong Yi Lee J Lennert Veerman Jan J Barendregt The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.
description	<h4>Background</h4>To examine the cost-effectiveness of providing laparoscopic adjustable gastric banding (LAGB) surgery to all morbidly obese adults in the 2003 Australian population.<h4>Methods and findings</h4>Analyzed costs and benefits associated with two intervention scenarios, one providing LAGB surgery to individuals with BMI >40 and another to individuals with BMI >35, with each compared relative to a 'do nothing' scenario. A multi-state, multiple cohort Markov model was used to determine the cost-effectiveness of LAGB surgery over the lifetime of each cohort. All costs and health outcomes were assessed from an Australian health sector perspective and were discounted using a 3% annual rate. Uncertainty and sensitivity analyzes were conducted to test the robustness of model outcomes. Incremental cost-effectiveness ratios (ICERs) were measured in 2003 Australian dollars per disability adjusted life year (DALY) averted. The ICER for the scenario providing LAGB surgery to all individuals with a BMI >40 was dominant [95% CI: dominant -$588] meaning that the intervention led to both improved health and cost savings. The ICER when providing surgery to those with a BMI >35 was $2,154/DALY averted [95% CI: dominant -$6,033]. Results were highly sensitive to changes in the likelihood of long-term complications.<h4>Conclusion</h4>LAGB surgery is highly cost-effective when compared to the $50,000/DALY threshold for cost-effectiveness used in Australia. LAGB surgery also ranks highly in terms of cost-effectiveness when compared to other population-level interventions for weight loss in Australia. The results of this study are in line with other economic evaluations on LAGB surgery. This study recommends that the Australian federal government provide a full subsidy for LAGB surgery to morbidly obese Australians with a BMI >40.
format	article
author	Yong Yi Lee J Lennert Veerman Jan J Barendregt
author_facet	Yong Yi Lee J Lennert Veerman Jan J Barendregt
author_sort	Yong Yi Lee
title	The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.
title_short	The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.
title_full	The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.
title_fullStr	The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.
title_full_unstemmed	The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.
title_sort	cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of australia.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/27aed08dcc6046d38553367b7c9ef176
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The cost-effectiveness of laparoscopic adjustable gastric banding in the morbidly obese adult population of Australia.

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