Cost-effectiveness of bariatric surgery compared with nonsurgical treatment in people with obesity and comorbidity in Colombia

Gil-Rojas, Yaneth; Garzón, Andrés; Lasalvia Rodriguez, Pieralessandro; Hernández, Fabián; Castañeda-Cardona, Camilo; Rosselli, Diego

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dc.rights.licence	Atribución-NoComercial 4.0 Internacional	*
dc.contributor.author	Gil-Rojas, Yaneth
dc.contributor.author	Garzón, Andrés
dc.contributor.author	Lasalvia Rodriguez, Pieralessandro
dc.contributor.author	Hernández, Fabián
dc.contributor.author	Castañeda-Cardona, Camilo
dc.contributor.author	Rosselli, Diego
dc.coverage.spatial	Colombia	spa
dc.date.accessioned	2020-03-27T20:25:50Z
dc.date.accessioned	2020-04-15T13:26:54Z
dc.date.available	2020-03-27T20:25:50Z
dc.date.available	2020-04-15T13:26:54Z
dc.date.created	2019-05-19
dc.identifier	https://www-sciencedirect-com.ezproxy.javeriana.edu.co/science/article/pii/S2212109919300500#!	spa
dc.identifier.issn	2212-1099 / 2212- 1102 (Electrónico)	spa
dc.identifier.uri	http://hdl.handle.net/10554/47900
dc.format	PDF	spa
dc.format.mimetype	application/pdf	spa
dc.language	spa	spa
dc.rights.uri	http://creativecommons.org/licenses/by-nc/4.0/	*
dc.source	Value in Health Regional Issues; Vol. 20 (2019)	spa
dc.title	Cost-effectiveness of bariatric surgery compared with nonsurgical treatment in people with obesity and comorbidity in Colombia	spa
dc.type	info:eu-repo/semantics/article
dc.type.hasversion	http://purl.org/coar/version/c_ab4af688f83e57aa
dc.description.quartilescopus	Q2	spa
dc.identifier.doi	https://doi.org/10.1016/j.vhri.2019.01.010	spa
dc.description.tipoarticulo	Artículo original	spa
dc.description.paginas	79-85	spa
dc.format.soporte	Papel / Electrónico	spa
dc.subject.keyword	Cost-effectiveness	spa
dc.subject.keyword	Cost-utility	spa
dc.subject.keyword	Bariatric surgery	spa
dc.subject.keyword	Obesity	spa
dc.subject.keyword	Pharmacologic treatment	spa
dc.description.abstractenglish	Background The increase in obesity prevalence and its relationship with multiple cardiovascular complications have raised the burden of obesity in the general population. Bariatric surgery has shown to be more effective in reducing weight than the traditional pharmacologic and nonpharmacologic treatments. Objective To evaluate the cost-effectiveness of this alternative compared with standard treatment in the Colombian context. Methods A Markov single cohort model was used to simulate the incremental cost per quality-adjusted life-year (QALY) gained every year over a base-case 5-year time horizon. The model considers 5 health states: comorbidity, remission, acute myocardial infarction, stroke, and death. Four comorbidity conditions were evaluated separately: diabetes, hypertension, dyslipidemia, and sleep apnea. The model was evaluated from a third-payer perspective. All costs were expressed in 2016 Colombian pesos ($1.00 = 3051 COP). A 5% annual discount rate was applied to both costs and outcomes. Results In baseline analysis, bariatric surgery was a cost-effective alternative compared with nonsurgical treatment in the diabetes and hypertension cohort with an incremental cost-effectiveness ratio of $6 194 899 and $43 689 527 per QALY gained, respectively. In the sleep apnea cohort, surgery has greater effectiveness and lower costs, which is why it is a dominant strategy. In the dyslipidemia cohort, bariatric surgery is dominated by the nonsurgical approach. Conclusion The current study provides evidence that bariatric surgery is a cost-effective alternative among some cohorts in the Colombian setting. For obese patients with sleep apnea or diabetes, bariatric surgery is a recommendable alternative (dominant and cost-effective, respectively) for the Colombian healthcare system.	spa
dc.type.local	Artículo de revista	spa
dc.contributor.corporatename	Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística