The cost of medications in the treatment of hypertension and diabetes in the morbidly obese is a significant healthcare burden. In this study we assessed the impact of gastric bypass surgery on medication costs over the course of a lifetime.
We performed a retrospective chart review of patients who had gastric bypass at the Palo Alto VA Health Care System from 2001 to 2007. Preoperative and postoperative medications to treat hypertension and diabetes were identified. Life expectancy was determined using CDC life expectancy tables and Framingham Heart Study data based on body mass index. Comparisons were made between the projected lifetime costs of diabetic and hypertensive medications with or without bariatric surgery using the Student’s paired t-test.
Of 106 patients who had gastric bypass, 90 had either hypertension or diabetes. Of these patients, 88 (83%) had hypertension and 60 (57%) had diabetes before surgery. Hypertension resolved in 44% and diabetes in 80% at one year after surgery. The projected average lifetime cost of medications to treat hypertension without and with gastric bypass surgery was $1,038.31 vs. $285.98 (p< 0.0001), respectively. To treat diabetes the difference was $10,504.86 vs. $1,139.46 (p< 0.0001) per person.
When the subset of patients whose hypertension and diabetes had completely resolved was excluded, the projected average lifetime cost of hypertensive medications without and with gastric bypass was $1,348.57 vs. $513.69 (p< 0.0006), respectively. The projected average lifetime cost of diabetic medications without and with surgery was $22,427.34 vs. $5,697.31 (p< 0.026) respectively.
Gastric bypass surgery results in a significant reduction in the lifetime cost of medications to treat hypertension and diabetes in the morbidly obese. These cost-savings are also significant in the subset of patients without complete resolution of their comorbid conditions after surgery.
Session: Podium Presentation
Program Number: S047