Medication utilization and annual health care costs in patients with type 2 diabetes mellitus before and after bariatric surgery

Martin A Makary, Jeanne Clark, Andrew D. Shore, Thomas Magnuson, Thomas Richards, Eric B Bass, Francesca Dominici, Jonathan Weiner, Albert W Wu, Jodi Segal

Research output: Contribution to journalArticle

Abstract

Objective: To examine the relationship of bariatric surgery with the use of diabetes medications and with total health care costs in patients with type 2 diabetes mellitus. Design: Westudied 2235 adults with type 2 diabetes and commercial health insurance who underwent bariatric surgery in the United States during a 4-year period from January 1, 2002, through December 31, 2005. We used administrative claims data to measure the use of diabetes medications at specified time intervals before and after surgery and total median health care costs per year. Setting: Seven states in the Blue Cross/Blue Shield Obesity Care Collaborative. Patients: Two thousand two hundred thirty-five patients with type 2 diabetes mellitus who underwent bariatric surgery. Results: Surgery was associated with elimination of diabetes medication therapy in 1669 of 2235 patients (74.7%) at 6 months, 1489 of 1847 (80.6%) at 1 year, and 906 of 1072 (84.5%) at 2 years after surgery. Reduction of use was observed in all classes of diabetes medications. The median cost of the surgical procedure and hospitalization was $29 959. In the 3 years following surgery, total annual health care costs per person increased by 9.7% ($616) in year 1 but then decreased by 34.2% ($2179) in year 2 and by 70.5% ($4498) in year 3 compared with a preoperative annual cost of $6376 observed from 1 to 2 years before surgery. Conclusions: Bariatric surgery is associated with reductions in the use of medication and in overall health care costs in patients with type 2 diabetes. Health insurance should cover bariatric surgery because of its health and cost benefits.

Original languageEnglish (US)
Pages (from-to)726-731
Number of pages6
JournalArchives of Surgery
Volume145
Issue number8
DOIs
StatePublished - 2010

Fingerprint

Bariatric Surgery
Health Care Costs
Type 2 Diabetes Mellitus
Blue Cross Blue Shield Insurance Plans
Health Insurance
Costs and Cost Analysis
Insurance Benefits
Cost-Benefit Analysis
Hospitalization
Obesity

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

@article{761b3952a6604482867f7c00989ee76a,
title = "Medication utilization and annual health care costs in patients with type 2 diabetes mellitus before and after bariatric surgery",
abstract = "Objective: To examine the relationship of bariatric surgery with the use of diabetes medications and with total health care costs in patients with type 2 diabetes mellitus. Design: Westudied 2235 adults with type 2 diabetes and commercial health insurance who underwent bariatric surgery in the United States during a 4-year period from January 1, 2002, through December 31, 2005. We used administrative claims data to measure the use of diabetes medications at specified time intervals before and after surgery and total median health care costs per year. Setting: Seven states in the Blue Cross/Blue Shield Obesity Care Collaborative. Patients: Two thousand two hundred thirty-five patients with type 2 diabetes mellitus who underwent bariatric surgery. Results: Surgery was associated with elimination of diabetes medication therapy in 1669 of 2235 patients (74.7{\%}) at 6 months, 1489 of 1847 (80.6{\%}) at 1 year, and 906 of 1072 (84.5{\%}) at 2 years after surgery. Reduction of use was observed in all classes of diabetes medications. The median cost of the surgical procedure and hospitalization was $29 959. In the 3 years following surgery, total annual health care costs per person increased by 9.7{\%} ($616) in year 1 but then decreased by 34.2{\%} ($2179) in year 2 and by 70.5{\%} ($4498) in year 3 compared with a preoperative annual cost of $6376 observed from 1 to 2 years before surgery. Conclusions: Bariatric surgery is associated with reductions in the use of medication and in overall health care costs in patients with type 2 diabetes. Health insurance should cover bariatric surgery because of its health and cost benefits.",
author = "Makary, {Martin A} and Jeanne Clark and Shore, {Andrew D.} and Thomas Magnuson and Thomas Richards and Bass, {Eric B} and Francesca Dominici and Jonathan Weiner and Wu, {Albert W} and Jodi Segal",
year = "2010",
doi = "10.1001/archsurg.2010.150",
language = "English (US)",
volume = "145",
pages = "726--731",
journal = "JAMA Surgery",
issn = "2168-6254",
publisher = "American Medical Association",
number = "8",

}

TY - JOUR

T1 - Medication utilization and annual health care costs in patients with type 2 diabetes mellitus before and after bariatric surgery

AU - Makary, Martin A

AU - Clark, Jeanne

AU - Shore, Andrew D.

AU - Magnuson, Thomas

AU - Richards, Thomas

AU - Bass, Eric B

AU - Dominici, Francesca

AU - Weiner, Jonathan

AU - Wu, Albert W

AU - Segal, Jodi

PY - 2010

Y1 - 2010

N2 - Objective: To examine the relationship of bariatric surgery with the use of diabetes medications and with total health care costs in patients with type 2 diabetes mellitus. Design: Westudied 2235 adults with type 2 diabetes and commercial health insurance who underwent bariatric surgery in the United States during a 4-year period from January 1, 2002, through December 31, 2005. We used administrative claims data to measure the use of diabetes medications at specified time intervals before and after surgery and total median health care costs per year. Setting: Seven states in the Blue Cross/Blue Shield Obesity Care Collaborative. Patients: Two thousand two hundred thirty-five patients with type 2 diabetes mellitus who underwent bariatric surgery. Results: Surgery was associated with elimination of diabetes medication therapy in 1669 of 2235 patients (74.7%) at 6 months, 1489 of 1847 (80.6%) at 1 year, and 906 of 1072 (84.5%) at 2 years after surgery. Reduction of use was observed in all classes of diabetes medications. The median cost of the surgical procedure and hospitalization was $29 959. In the 3 years following surgery, total annual health care costs per person increased by 9.7% ($616) in year 1 but then decreased by 34.2% ($2179) in year 2 and by 70.5% ($4498) in year 3 compared with a preoperative annual cost of $6376 observed from 1 to 2 years before surgery. Conclusions: Bariatric surgery is associated with reductions in the use of medication and in overall health care costs in patients with type 2 diabetes. Health insurance should cover bariatric surgery because of its health and cost benefits.

AB - Objective: To examine the relationship of bariatric surgery with the use of diabetes medications and with total health care costs in patients with type 2 diabetes mellitus. Design: Westudied 2235 adults with type 2 diabetes and commercial health insurance who underwent bariatric surgery in the United States during a 4-year period from January 1, 2002, through December 31, 2005. We used administrative claims data to measure the use of diabetes medications at specified time intervals before and after surgery and total median health care costs per year. Setting: Seven states in the Blue Cross/Blue Shield Obesity Care Collaborative. Patients: Two thousand two hundred thirty-five patients with type 2 diabetes mellitus who underwent bariatric surgery. Results: Surgery was associated with elimination of diabetes medication therapy in 1669 of 2235 patients (74.7%) at 6 months, 1489 of 1847 (80.6%) at 1 year, and 906 of 1072 (84.5%) at 2 years after surgery. Reduction of use was observed in all classes of diabetes medications. The median cost of the surgical procedure and hospitalization was $29 959. In the 3 years following surgery, total annual health care costs per person increased by 9.7% ($616) in year 1 but then decreased by 34.2% ($2179) in year 2 and by 70.5% ($4498) in year 3 compared with a preoperative annual cost of $6376 observed from 1 to 2 years before surgery. Conclusions: Bariatric surgery is associated with reductions in the use of medication and in overall health care costs in patients with type 2 diabetes. Health insurance should cover bariatric surgery because of its health and cost benefits.

UR - http://www.scopus.com/inward/record.url?scp=77955560922&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955560922&partnerID=8YFLogxK

U2 - 10.1001/archsurg.2010.150

DO - 10.1001/archsurg.2010.150

M3 - Article

C2 - 20713923

AN - SCOPUS:77955560922

VL - 145

SP - 726

EP - 731

JO - JAMA Surgery

JF - JAMA Surgery

SN - 2168-6254

IS - 8

ER -