Cost-effectiveness of an educational healthcare circuit for bariatric surgery in France

Alejandra Duenas, Christine Di Martinelly, A. Aelbrecht, P.-E. Allard and J. Rousseaux
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Christine Di Martinelly: IESEG Business School - UCL - Université catholique de Lille - IESEG - UCL - Université catholique de Lille, LEM - Lille économie management - UMR 9221 - UA - Université d'Artois - UCL - Université catholique de Lille - Université de Lille - CNRS - Centre National de la Recherche Scientifique
A. Aelbrecht: IESEG Business School - UCL - Université catholique de Lille - IESEG - UCL - Université catholique de Lille
P.-E. Allard: Ramsay Générale de Santé - Hôpital Privé La Louvière
J. Rousseaux: Ramsay Générale de Santé - Hôpital Privé La Louvière

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Abstract: Objectives An educational healthcare circuit (EHC) is proposed with the objective of preventing weight recovery of patients after bariatric surgery through education and lifestyle change. The objective of this study was to measure the viability of the EHC (shared medical appointments [SMAs] combined with bariatric surgery) through cost-effectiveness analysis. The EHC presented in this study is innovative because it offers a multidisciplinary approach based on medical, psychological and dietetic expertise to combat obesity. The strategy is to give the patient a diagnosis and then a personalised follow-up. Study design A mathematical model based on a decision tree (1 year) and a Markov model (10 years) to measure the efficiency and cost of an EHC in comparison with the customary care offered in France were built. Methods The effects of the EHC were observed for the prevalence of type 2 diabetes and the risk of cardiovascular disease. The chosen financial perspective is from the point of view of the French social security system. Results The EHC records an incremental cost-effective ratio (ICER) of € 48,315.43 per quality-adjusted life year (QALY) over a 1-year horizon and € 28,283.77 per QALY over 10 years (with discount rate of 8%: € 25,362.85 per QALY). Conclusion The results suggest that an EHC is more expensive yet more effective than usual care. That is, in the short term, the costs are high, but at 10 years, the treatment is cost-effective, representing a feasible alternative for those patients who qualify for bariatric surgery in France.

Keywords: Obesity; Bariatric surgery; Cost-effectiveness; Type 2 diabetes; Cardiovascular diseases (search for similar items in EconPapers)
Date: 2019-07
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Published in Public Health, 2019, 172, pp.43-51. ⟨10.1016/j.puhe.2019.04.015⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-02167165

DOI: 10.1016/j.puhe.2019.04.015

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