Ireland to assess metabolic surgery for T2Dm treatment and obesity

The Health Information and Quality Authority (HIQA) in Ireland has begun a health technology assessment (HTA) of metabolic surgery for the treatment of type 2 diabetes (T2D) and obesity. The aim of the assessment is to establish the clinical- and cost-effectiveness of metabolic surgery for the treatment of type 2 diabetes and obesity in Ireland. The assessment will also estimate the budget impact, organisational and resource implications associated with introducing a metabolic surgery programme.

“Obesity and type 2 diabetes are significant public health concerns in Ireland and internationally. Obesity increases the risk of developing type 2 diabetes which can lead to long-term complications including damage to the heart, kidneys or eyes,” said Dr Conor Teljeur, HIQA’s Chief Scientist. “It is important that effective treatment options are available for patients with both type 2 diabetes and obesity to reduce the burden of disease on the healthcare system. The benefits of metabolic surgery are not limited to weight-loss. Surgery may have additional benefits for people with type 2 diabetes such as improvements in blood sugar control. This assessment will consider whether or not metabolic surgery should be incorporated into the clinical care pathway for type 2 diabetes in Ireland.”


HIQA agreed to undertake the HTA following a formal request from the Clinical Lead of the National Clinical Programme for Diabetes in the Health Service Executive (HSE), with support from the National Clinical Programme for Obesity.


It is estimated that 160,000 people in Ireland have T2D. Between 2009 and 2019, cases with a diagnosis of T2D represented, on average, 25% of all cases who underwent a primary bariatric surgery procedure in Irish public hospitals.


At present, access to bariatric surgery for patients with obesity and obesity-related diseases is provided through the National Clinical Programme for Obesity or accessed through private healthcare systems in Ireland or abroad.


The assessment will also estimate the budget impact, organisational and resource implications associated with introducing a metabolic surgery programme and the outcome will be provided as advice to the Minister for Health to inform a decision on introducing a metabolic surgery programme, in addition to existing bariatric surgery services in Ireland.


HIQA has established an expert advisory group comprising representatives from key stakeholder groups who will advise the HTA evaluation team during the course of this assessment.


The HTA is scheduled to be finalised in early 2022 and the protocol for the assessment will be published on the HTA website.