Procedure-less intragastric balloon is cost-effective in obesity management
Procedure-less intragastric balloon, either as a bridge to bariatric surgery or as a stand-alone treatment, was cost-effective and improved health outcomes, according to research published in PLOS ONE.
“Bariatric surgery is the most effective and cost-effective treatment for obesity compared with other obesity treatments. However, access to bariatric surgery is extremely limited owing to financial and insurance constraints and shortage of bariatric surgeons,” Shweta Mital, Memorial University of Newfoundland, and colleagues wrote. “Given the vast unmet need for obesity treatment and the unique advantages of procedure-less intragastric balloons (PIGBs) relative to other intragastric balloons (IGBs) and bariatric surgery, albeit with lower weight loss than bariatric surgery, an important question for policymakers and clinicians is whether treatment with PIGB is cost-effective — either as stand-alone treatment or as bridge to bariatric surgery.”
To compare the cost and weight loss effects of PIGB, researchers developed a Markov microsimulation model that assessed treatment strategies among 10,000 patients with obesity aged 18 years to 64 years. Patients underwent either PIGB, gastric bypass or sleeve gastrectomy as stand-alone treatments, PIGB as a bridge to gastric bypass or sleeve gastrectomy or no treatment. Researchers measured effectiveness in terms of quality-adjusted life years (QALYs) and estimated Incremental Cost Effectiveness Ratio (ICER) as the difference in total cost to the difference in total QALYs.
According to simulation results, PIGB as a bridge to bariatric surgery was less costly and more effective compared with bariatric surgery alone in achieving a lower post-operative BMI. Specifically, PIGB paired with sleeve gastrectomy was the most cost-effective with an ICER of $3,781 per QALY gained. Though PIGB is not cost-effective compared with bariatric surgery alone, researchers noted it is more cost-effective compared with no treatment and produced an ICER of $21,711 per QALY.
“Offering PIGB as a first-line treatment to all patients with morbid obesity prior to bariatric surgery yields cost savings and better health outcomes compared with bariatric surgery alone,” Mital and colleagues concluded. “Furthermore, for patients who lack access to or are unwilling to undergo bariatric surgery, treatment with PIGB alone is cost effective compared with no treatment.”