Bariatric surgery saves money and prolongs lives
There are more than 670 million people worldwide who are obese – with serious consequences for themselves and an enormous cost to the healthcare system. A recent MedUni Vienna study, conducted jointly with the Institute of Pharmaceutical Economic Research (Evelyn Walter) and the Austrian Society of Bariatric Surgery and led by Gerhard Prager (Department of Surgery), shows that bariatric surgery, such as a gastric bypass, for example, not only saves a lot of money but also improves quality-of-life and extends life expectancy. On 26 May 2018, there will be an action day for obesity patients and interested parties in MedUni Vienna's Lecture Center in Vienna General Hospital.
If left untreated, morbid obesity leads to many secondary diseases such as diabetes, cardiovascular disease, fatty liver or hyperlipidaemia (a generally elevated blood concentration of cholesterol and triglycerides). In the current study, accurate calculations have now shown that a metabolic surgical intervention, performed at the right time, can save a lot of money and suffering. "We calculated what would happen in 20 years time, if this intervention were not made, the costs that obese patients would save and their gain in terms of extended life expectancy," explains Prager, who is also Head of the Obesity Outpatient Clinic in Vienna General Hospital.
The main findings: the saving is €24,600 per patient in costs associated with the condition. Every patient who has developed diabetes over these 20 years gains an extra 3.7 years of life; every patient who has developed cardiovascular disease gains an extra 3.4 years of life; every patient who has developed fatty liver gains an extra 3.7 years of life; and patients who have developed hyperlipidaemia over these 20 years gain approximately an extra year of life.
People are considered obese when they have a body mass index (BMI) in excess of 30 but the Health Insurance Fund will only fund the cost of the operation from a BMI of 35, plus a diagnosis of diabetes (without diabetes from a BMI of 40 kg/m2). The MedUni Vienna experts would like to see the Swiss protocol applied in Austria: there the Health Insurance Fund will pay from a BMI of 35 upwards without any further conditions being imposed. Around 400 such operations are carried out each year at the Department of Surgery of MedUni Vienna/Vienna General Hospital, whereas twice this number would be desirable, says Prager. Throughout the whole of Austria, 3,500 such interventions are performed each year, in Switzerland this number is 6,000.
Says Prager: "This will save our healthcare system a great deal of money. Not least because it will mean far fewer patients go on to ultimately develop cancer – and this applies to women in particular."
The operation has been shown to have lasting beneficial consequences: "Our studies show that the long-term effects make gastric bypass the most effective treatment for more severe obesity. Even ten years on from the operation, most patients are considerably lighter than they were before it."