Impact of Bariatric Surgery on Medication Costs and Disease Burden in Obesity: A Retrospective Cohort Study.

Abstract

Introduction: Obesity is a highly prevalent chronic disease associated with substantial morbidity, multiple comorbidities, and a significant burden on healthcare systems. Metabolic bariatric surgery (MBS) is effective in achieving weight loss and improving obesity-related comorbidities, potentially reducing pharmacotherapy requirements and overall disease burden. Nevertheless, evidence from Portuguese real-world clinical practice remains limited. Therefore, this study aimed to provide the first Portuguese evaluation of the impact of MBS on pharmacotherapy-related healthcare costs and on the prevalence and burden of obesity-associated comorbidities.

Methods: A retrospective cohort study was conducted. Annual pharmacotherapy costs and changes in the prevalence and burden of obesity-associated comorbidities, measured using Years Lived with Disability (YLD), were compared before and 3 years after surgery.

Results: Three years after MBS, the mean annual pharmacotherapy cost per patient decreased by €56.11 (p < 0.05). Reductions in medication costs were observed for antihypertensive, lipid-lowering, and antidiabetic therapies (all p < 0.05). The prevalence of obesity-related comorbidities also decreased, particularly hypertension, type 2 diabetes mellitus, dyslipidemia and asthma (all p < 0.05). Correspondingly, the estimated burden of disease decreased, with mean YLD declining from 0.022 before surgery to 0.014 3 years after surgery (p < 0.05).

Conclusion: Over 3 years of follow-up, MBS was associated with reductions in medication costs, the prevalence of obesity-related comorbidities, and overall disease burden. These findings highlight the clinical and economic benefits of MBS in the management of obesity and its associated conditions over the medium term.