Profitability is at the heart of larger problem with access to treatment surgical of diabetes, said Dr. Francesco Rubino, Director of metabolic surgery gastrointestinal at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and Director of the Congress.
Today, about 285 million people worldwide suffer from type 2 diabetes, and notes that the number is expected to double by 2030, says Dr. Rubino, who is also Professor of surgery at the Weill Cornell Medical College. "The need for effective, potentially curative treatment is urgent."
According to an analysis presented at the Conference by Australian researcher, bariatric surgery to treat type 2 diabetes has proved to be very profitable in the countries which were, in this search - United States, the United Kingdom, Australia and in some sites in Europe.
The review also found that several studies have established that bariatric surgery was not only cost effective, but economical, explains Catherine Keating, senior researcher of the unit of the health of the economy of Deakin University at Melbourne who made the presentation. For obese patients diagnosed with diabetes type 2 in the two years preceding the surgery Bariatric, a study revealed that the initial costs of surgery could recover completely on the prevention of future costs of health care to treat type 2 diabetes. This study was conducted with a clinical trial that concluded this remission of type 2 has been five times higher than diabetes surgically in patients, with respect to those who receive conventional treatment, he said.
"This group of patients with Bariatric Surgery product cost savings and health benefits," says Ms. Keating. "It is the strongest reason for the application of this treatment for economic reasons."
Treatment of studies have shown that procedure Bariatric, initially developed for the treatment of morbid obesity, improve or normalize blood glucose levels, reduce or even eliminate the need for drugs and reduce the risk of diabetes-related deaths.
A series of new studies of profitability were discussed at the meeting, said Dr. David Reed flight, who co-chairs the runway of the policy of the Congress. "As health care costs soar, the obligation of all those involved in this issue is currently aware of the resources in a way that they are in place for the treatment and prevention of diabetes and explore what the future impact on the resources of health might be if the surgery becomes an important part" the response of the public health for diabetes is epidemic "said Dr. flight, Professor of surgery at the school of Washington University of medicine and health services.
"The Ministers of health, economists, payers, and politicians have a crucial role in determining the future of this issue, and we expected a dialogue which is robust in this track of the Congress," he said.
The studies examined whether the costs of surgery, estimated between $ 15,000 and $24,000 in the United States - are justified by its effectiveness and its potential to save the future medical treatment for diseases associated with obesity as type 2 diabetes.
"The identification of efficiency for Bariatric Surgery information are now very strong." It has been proven to reduce disease, prolong life expectancy and improve the quality of life, "says Ms. Keating. "However, in the context of limited health budgets, the authorities of the State of the world of health care financing must be informed by an assessment of the costs of treatment and effectiveness."
For its analysis, Ms. Keating considered 16 published studies who watched the cost-effectiveness of Bariatric, gastric bypass and gastric banding surgery. Ten studies severely reviewed procedures in obese patients (those with a body mass index, or BMI, of 35 years or more) that they are not for diabetes type 2, and six watched patients with type 2 diabetesdont body mass index was 30-40 (moderately to severely obese).
Each country establishes their own measure of profitability. The United States, the profit threshold is $ 50,000 per life year adjusted for quality (QALY), which is defined as a year of human life, with some adjustments due to illness or disability.
Ms. Keating review concluded that the very profitable bariatric procedure in the two populations that are studied (patients without diabetes and a BMI more of 35 years) and patients with diabetes or a BMI of 30 or 40, but was twice as profitable in the last category - patients with type 2 diabetes.
"It is probably because the patients with diabetes have poor health and thus more benefits can be achieved through surgical intervention in terms of quality of life, life expectancy and the prevention of future health care costs" he said. " Without treatment, diabetes type 2 patients and support permanent disease and the rising costs of health care".
Between the costs associated with the medical treatment of diabetes type 2 are the treatment of complications affecting the eyes, the heart, kidneys, and members. Long term costs include ambulatory care, prescription drugs and diabetes-related hospitalizations and surgeries, including amputations.
The analysis showed that by surgery which deal with diabetes type 2 patients who are newly diagnosed (diagnosis of less than five years before the surgery) is more cost-effective that the use of surgery with patients whose diabetes was established more than five years. For example, a U.S. study in 2009 found that failure of surgery had rates of return of $7,000 / QALY and 12 000 $/ SIPA for severely obese patients with diabetes diagnosed and set, respectively recently.
"Targeting recently received a diagnosis of diabetes is likely to be cost-effective because delivery successful diabetes rates are higher in this group than in people with diabetes type 2 who are prepared, says Ms. Keating." "" Some studies that analyse, especially those targeting therapy for diabetes type 2 patients recently diagnosed, have found that surgery costs can be recovered fully through the prevention of future health care costs. "This excellent result is quite rare."
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