AI Article Synopsis
- * Data from over 6,000 patients revealed varying rates of LLT reimbursement and treatment discontinuation after four years, indicating different sequenced surgical impacts.
- * Findings showed that CMBS significantly decreases the costs and necessity for LLT in dyslipidemia patients over a four-year follow-up period.
Article Abstract
Background: The need for conversional metabolic and bariatric surgery (CMBS) is still growing. No large-scale prospective cohort studies have assessed changes in lipid-lowering treatment (LLT) after CMBS.
Objectives: This study assesses and compares the effectiveness of the 4 main CMBS sequences after sleeve gastrectomy (SG) and adjustable gastric banding (AGB) on reimbursement and cost of LLT.
Setting: France.
Methods: This nationwide observational population-based cohort study analyzed data from the French National Health Insurance database. It included all patients who had undergone primary SG and AGB in France between January 1, 2012, and December 31, 2014, and followed until December 31, 2020. The study assessed LLT reimbursement evolution and costs across 4 different CMBS sequences.
Results: During follow-up, 6396 patients underwent the 4 CMBS sequences: SG-RYGB (Roux-en-Y gastric bypass) (n = 2400), AGB-SG (n = 2277), AGB-RYGB (n = 1173), and SG-SG (n = 546), with a rate of LLT reimbursement of 9.8%, 3.6%, 6.6%, and 7.9%, respectively, in the year before CMBS. The rates of discontinuation of treatment at 2 and 4 years were 41.9%, 35.4%, 45.6%, 20.5% and 45.6%, 31.3%, 64.3%, 31.6%, respectively. At 4 years, the median [interquartile range] annual costs (euros) per patient were significantly lower (P < .01) than the costs in the year before CMBS for each sequence: 86.8 [57.3; 136.1] versus 38.0 [.0; 64.6], 79.1 [50.5; 120.1] versus 50.4 [15.6; 64.1], 89.0 [66.5; 139.6] versus .0 [.0; 58.8], and 89.8 [66.1; 121.4] versus 63.1 [.0; 93.4].
Conclusions: Our study underlines the effectiveness of CMBS in significantly reducing the need and associated costs of LLT for patients with dyslipidemia over a 4-year period.
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| http://dx.doi.org/10.1016/j.soard.2024.08.019 | DOI Listing |
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Article Synopsis
- * Data from over 6,000 patients revealed varying rates of LLT reimbursement and treatment discontinuation after four years, indicating different sequenced surgical impacts.
- * Findings showed that CMBS significantly decreases the costs and necessity for LLT in dyslipidemia patients over a four-year follow-up period.
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