Abstract

Objective: To determine the within-trial cost-efficacy of surgical therapy relative to conventional therapy for achieving remission of recently diagnosed type 2 diabetes in class I and II obese patients.

Methods: Efficacy results were derived from a two-year randomized controlled trial. A health sector perspective was adopted and within-trial intervention costs included gastric banding surgery, mitigation of complications, outpatient medical consultations, medical investigations, pathology, weight loss therapies and medication. Resource use was measured based on data drawn from a trial database and patient medical records and valued based on private hospital costs and government schedules in 2006 Australian dollars (AUD). An incremental cost-effectiveness analysis was undertaken. An

Results: Mean per patient two-year intervention costs were surgical therapy: AUD13,400 and conventional therapy: AUD3,400, with LAGB surgery accounting for 85% of the difference. Outpatient medical consultation costs were 3 times higher amongst surgical patients, whilst medication costs were 1.5 times higher for conventional patients. The costs differences were primarily in the first six months of the trial. Relative to conventional therapy, the incremental cost-effectiveness ratio for surgical therapy was AUD16,600 per case of diabetes remitted (currency exchange :1 AUD: USD 0.74).

Conclusion: Surgical therapy appears to be a cost-effective option for managing type 2 diabetes in obese patients.