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Bariatric surgery reduces spending on T2DM and hypertension meds

Patients reduced spending on diabetes medications by nearly 65 percent and spending on high blood pressure medications by more than a third three to six months after the operation

Patients with severe obesity who undergo bariatric surgery cut their spending on diabetes medications by nearly 65 percent and spending on high blood pressure medications by more than a third three to six months after the operation, according to new research from Rush Medical College in Chicago presented at an American Society for Metabolic and Bariatric Surgery (ASMBS) national clinical symposium on obesity prevention, treatment and research. The significant reduction in spending after surgery in such a short time led researchers to conclude that costs savings after bariatric surgery are not dependent on weight loss alone.

Researchers retrospectively examined data from 210 patients and found patients prior to surgery spent an average of US$225 per month on diabetes drugs and US$71 on hypertensive medications. Between three to six months after bariatric surgery, spending on diabetes medications dropped to between US$70 and US$80. Costs for hypertensive medications were reduced to between US$47 and US$54. Prices attributed to each medication was based on the standardised pricing guide provided by Drugs.com.

“The safety and effectiveness of bariatric surgery is well-established and while health improvement is clearly the most important goal, the significant reduction in prescription drug costs due to disease remission or improvement is an added bonus,” said Dr Naomi Parrella, study co-author and assistant professor in the department of family medicine and the department of surgery at Rush Medical College. “While medications play an important role in disease management, patients, physicians, and insurers can agree on the further benefit from the potential financial impact of bariatric surgery along with the myriad of clinical benefits.”

Studies have shown bariatric surgery helps improve or resolve more than 40 obesity-related diseases and conditions. According to the ASMBS, surgery improves diabetes in nearly 90 percent of patients and causes it to go into remission in 78 percent of patients. Bariatric surgery also has been shown to be an effective strategy for blood pressure control in a broad population of patients with obesity and hypertension.

“This new study adds to the mounting evidence that bariatric surgery is a cost effective treatment option that results in the improvement or resolution of diseases including obesity, diabetes and high blood pressure,” said Dr Eric J DeMaria, president of the ASMBS and professor and chief, Division of General/Bariatric Surgery, Brody School of Medicine at East Carolina University in Greenville, NC, who was not involved in the study.

Diabetes has become the most expensive chronic disease in America, according to the American Diabetes Association. In 2017, the cost was US$327 billion. Spending on diabetes accounts for one in four healthcare dollars in the US with people with diabetes incurring average medical expenditures of about US$9,600 per year. The Centers for Disease Control and Prevention estimates more than 100 million U.S. adults are now living with diabetes or prediabetes.

According to a 2018 study published in the Journal of the American Heart Association, those with hypertension incur almost US$2,000 more in annual healthcare costs. People with hypertension had two-and-a-half times the inpatient costs, nearly double the outpatient costs, and nearly triple the prescription medication costs compared to those without high blood pressure. The AHA estimates 103 million Americans have high blood pressure, which puts them at greater risk for heart attacks and strokes.

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