Drugs costs before and after bariatric surgery: A systematic review

Tags: Poster
Stein A1, Lopes E2, Heineck I3, Athaydes G4, Souto K5, Meinhardt N5
1Grupo Hospitalar Conceição/Ufcspa/Ulbra, Brazil, 2Epidemiology Post-graduation Course, Ufrgs-Brazil, 3Pharmaceutical Science Postgraduation Course, Ufrgs-Brazil, 4Pharmaceutical Course, Ufrgs-Brazil, 5Obesity Unit Grupo Hospitalar Conceição

Background: Surgical treatment has shown to be the only effective method for keeping the weight loss for a long period in morbidly obese people. The surgical procedure requires long-term monitoring, both nutritional and pharmacologic.

Objectives: To review the impact of bariatric surgery on drug costs.

Methods: We have used the following MESh terms: obesity, bariatric surgery and drug costs, and have searched in nine databases (including Medline, Embase and Cochrane Library), until January 2011. In addition, reference lists were reviewed and contacted expertsto identify additional published and unpublished references. Inclusion criteria: adults, BMI >35 kg/m2, drug use and comparision of costs before and after surgery. Articles were reviewed by two independent reviewers and differences were resolved by consensus.

Results: The search identified 501 citations, and ten articles were identified as potentially relevant. Three articles wereexcluded, one that compared cost between obese and nonobese patients, another one in which compared total costs in health, although, cost had not been considered and the last one compared drug costs between surgical therapy and conventional therapy. The studies included in this review were cohorts, ranging from 50 to 965 patients. The systematic review has shown a decrease on drug expenditure between pre and post-operative, which was statistically significant (p < 0.05). Although, one of the studies had found an increase of 32.1% in expenditure after a 6-year monitoring.

Conclusions: Even though, the studies that were reviewed have demonstrated cost reduction with regards to the use of drugs, the time framework in the postoperative period is short. The study that has followed patients for a longer period of time showed a different outcome in relation to others, ie an increase in drug spending after surgery.