A 10-Year Cost-Effectiveness Analysis of Metabolic and Bariatric Surgery in Adolescents
Authors' conclusion
In this economic evaluation of bariatric surgery for adolescents with severe obesity, both RYGB and sleeve gastrectomy were determined to be cost-effective when compared with no surgery. However, sleeve gastrectomy was estimated to be the cost-effective strategy over a 10-year time horizon when simultaneously comparing all 3 interventions. These findings complement established clinical evidence of the long-term benefits of MBS, supporting its economic value.
Study context
- Population
- Simulated adolescents with severe obesity, US; inputs from Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) data, literature and national databases; baseline age 17 years, BMI 52.1, 75.0% female, 13.3% T2Dsimulated cohort
- Participants
- 100,000 adolescents
- Comparison
- RYGB vs sleeve gastrectomy vs no surgery
- Outcome
- QALYs, costs (2022 US dollars) and incremental cost-effectiveness ratios (ICERs)
- Follow-up
- 10 years
Methodological detailscost-effectiveness analysis using a microsimulation model, 10-year time horizon, US health care sector perspective, costs and quality-adjusted life-years (QALYs) discounted at 3.0% annually, willingness-to-pay (WTP) threshold $100 000 per QALY gained, Data analyzed April 2023 to October 2025
- Cost-effectiveness analysis using a microsimulation model
- 10-year time horizon
- US health care sector perspective
- Costs and QALYs discounted at 3.0% annually
- WTP threshold $100 000 per QALY gained
- Data analyzed April 2023 to October 2025
Main finding
As reported in the abstract
ICER
$41 164 per QALY gained
Sleeve gastrectomy vs No surgery · cost-effective strategy
ICER
$557 751 per QALY gained
RYGB vs Sleeve gastrectomy · RYGB yielded the most QALYs
ICER
$50 271 per QALY gained
RYGB vs No surgery · direct comparison; cost-effective
Further findings
Sensitivity analyses
- Sleeve gastrectomy was consistently the cost-effective strategy
Original publication
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