Publicly funding bariatric surgery for obese people can make economic sense

Publicly funding bariatric surgery for obese people can make economic sense

Publicly funding bariatric surgery for obese people can make economic sense, according to research done at the Royal Prince Alfred Hospital in Sydney.

The research team found obese people who had publicly-funded surgery lost significant weight, with diabetes, hypertension and sleep apnoea resolved in more than half of patients within a year of the procedure. 

Although there has been doubts about the motivation of obese patients whose surgery is fully subsidised, the study suggests "patients reliant on public health care maintain sufficient intrinsic motivation" to lose weight. 

The team, led by Associate Professor Tania Markovic, analysed data from obese patients who underwent publicly-funded bariatric surgery and found there were "marked reductions" in type 2 diabetes, hypertension, lipid disturbances such as cholesterol, and sleep apnoea post-surgery.

The research, published in the Medical Journal of Australia on Monday, found 65 patients lost an average of 17 per cent of their pre-operative weight three months after surgery, 26 per cent within a year and 29 per cent within two years. 

Their body mass index decreased from an average of 48.2 before surgery to 35.7 by two years. 

Associate Professor Markovic said the study had found there were "benefits in almost all the common complications related to obesity", such as diabetes, hypertension and sleep apnoea.

"Obesity tends to affect more lower socio-economic groups and currently bariatric surgery is largely in the private sector," she said.

"It's an expensive procedure that's not covered by Medicare. These are the patients that are often most in need of the surgery who miss out on it. We found these patients do do well and when you do the economics, the cost analysis, one could argue that it is certainly worthwhile when you consider how expensive it is to look after somebody who has got, for instance, type 2 diabetes largely related to their weight."

Associate Professor Markovic said there could many medical conditions associated with obesity, which in themselves could be costly to treat. 

"If we just look at something like type 2 diabetes, I think, we quoted in the order of $15,000 a year but there can be other problems, there can be sleep apnoea, respiratory failure, gastrointestinal problems," she said. 

"The cost of somebody with complicated obesity with medical problems is high."

The study's authors wrote that improved access to publicly-funded bariatric surgery could "justifiably reduce the health inequalities for those most in need".  

The research appears to bolster the ACT government's move to provide publicly fund bariatric surgery in 2014-15. The funding will pay for about 13 procedures. 

No surgeries have yet been performed. 

An ACT Health spokeswoman said patients had to meet strict eligibility criteria. 

Patients must be aged over 18, have a BMI greater than 40 and have been referred to the Obesity Management Service by their GP. They also need to be assessed by the Obesity Management Service as meeting the "criteria for surgical intervention", the spokeswoman said. 

Associate Professor Markovic was hopeful consideration for increasing the supply publicly-funded bariatric surgeries in Australia would be boost by her team's research.