Bariatric Surgery can Lead to Net Cost Savings to Health Care Systems: Results from a Comprehensive European Decision Analytic Model

Research output: Contribution to journalArticle


The objective of the present study was to evaluate the cost-utility of bariatric surgery in a lifetime horizon from a Swedish health care payer perspective. A decision analytic model using the Markov process was developed covering cardiovascular diseases, type 2 diabetes, and surgical complications. Clinical effectiveness and safety were based on the literature and data from the Scandinavian Obesity Surgery Registry. Gastric bypass, sleeve gastrectomy, and gastric banding were included in the analysis. Cost data were obtained from Swedish sources. Bariatric surgery was cost saving in comparison with conservative management. It also led to a substantial reduction in lifetime risk of events: from a 16 % reduction in the risk of transient ischaemic attacks to a 62 % reduction in the incidence of type 2 diabetes. Over a lifetime, surgery led to savings of a,not sign8408 and generated an additional 0.8 years of life and 4.1 quality-adjusted life years (QALYs) per patient, which translates into gains of 32,390 quality-adjusted person-years and savings of a,not sign66 million for the cohort, operated in 2012. Analysis of the consequences of a 3-year delay in surgery provision showed that the overall lifetime cost of treatment may be increased in patients with diabetes or a body mass index > 40 kg/m(2). Delays in surgery may also lead to a loss of clinical benefits: up to 0.6 life years and 1.2 QALYs per patient over a lifetime. Bariatric surgery, over a lifetime horizon, may lead to significant cost savings to health care systems in addition to the known clinical benefits.


  • Oleg Borisenko
  • Daniel Adam
  • Peter Funch-Jensen
  • Ahmed R. Ahmed
  • Rongrong Zhang
  • Zeynep Colpan
  • Jan Hedenbro
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Surgery
  • Health Care Service and Management, Health Policy and Services and Health Economy


  • Bariatric surgery, Cost-utility analysis, Cost-effectiveness analysis, Health economics, Cost, Sweden
Original languageEnglish
Pages (from-to)1559-1568
JournalObesity Surgery
Issue number9
Publication statusPublished - 2015
Publication categoryResearch