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A recent analysis published in Surgical Endoscopy has revealed that the cost of anti-obesity medications, such as liraglutide (Saxenda) and semaglutide (Wegovy), can surpass that of metabolic and bariatric surgery within less than a year. Researchers from the USF Health Morsani College of Medicine, Tampa, FL, compared the cumulative cost of pharmacotherapy using GLP-1 receptor agonists with the one-time expenses of surgical procedures like sleeve gastrectomy and Roux-en-Y gastric bypass. This study brings attention to the long-term cost benefits of bariatric surgery, especially for patients and healthcare systems.
Key Findings: Surgery vs. Drugs
Bariatric surgery, a procedure widely recognized for its effectiveness in addressing obesity and metabolic syndrome, was found to offer significant long-term cost-saving benefits. The researchers noted that metabolic surgery not only leads to better health outcomes but also results in reduced medication usage, fewer clinic and emergency room visits, and decreased all-cause mortality. This translates into substantial financial savings over time.
The study’s authors emphasized, “Bariatric surgery offers a more permanent and rapid resolution to obesity and metabolic syndrome, with cost-saving benefits in the long-term.”
In contrast, medications like liraglutide and semaglutide, while effective for weight loss, require ongoing usage. Weekly injections of these drugs are associated with high cumulative costs, often surpassing the one-time cost of surgery within a year. Given that both surgical and drug-based treatments are aimed at reducing the health risks of obesity, the financial aspects play a pivotal role in treatment decisions for both patients and insurers.
Expert Opinions
Ann M. Rogers, MD, ACS FASMBS, President of the American Society for Metabolic and Bariatric Surgery (ASMBS), highlighted the efficacy of metabolic surgery: “Studies consistently show the efficacy of metabolic surgery in achieving long-term diabetes remission and substantial weight loss, far surpassing results achieved with medical management or diets and exercise alone. This not only results in better health but in significant cost savings too—yet another reason for patients to consider surgery and insurers to expand access to the gold standard of obesity treatment.”
The ASMBS reports that nearly 280,000 metabolic and bariatric procedures were performed in the U.S. in 2022, representing just 1% of those eligible based on BMI. Meanwhile, the Centers for Disease Control and Prevention (CDC) estimates that 40% of U.S. adults suffer from obesity, with severe obesity affecting approximately 1 in 10 individuals.
Implications for Healthcare Access
While metabolic and bariatric surgery offers long-term savings and health benefits, access to these procedures remains limited. A significant percentage of eligible patients opt for or have access only to pharmacotherapy due to coverage restrictions or personal preference. However, as this analysis demonstrates, the financial argument for expanding access to surgery becomes increasingly compelling.
As the obesity epidemic continues to rise globally, this study underscores the importance of considering both the immediate and long-term costs of treatment options. For patients struggling with obesity, bariatric surgery may not only offer a more effective solution but also one that proves more cost-efficient in the long run.
Conclusion
This analysis provides critical insights for both patients and healthcare providers when deciding between long-term medication use and surgical intervention. With the increasing financial burden of anti-obesity drugs, bariatric surgery may emerge as the more cost-effective option for treating obesity and its related conditions. As the debate over the most effective and accessible treatments continues, this research could shape future decisions regarding insurance coverage and healthcare policies.
For more information, refer to the full study: Salvatore Docimo et al., “A cost comparison of GLP-1 receptor agonists and bariatric surgery: what is the break-even point?” Surgical Endoscopy (2024). DOI: 10.1007/s00464-024-11191-1.
