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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EObesity is increasing in the United States and has associated health care costs, including prescription drugs. Some studies suggest that health care costs may be lower after bariatric surgery, whereas other studies show no long-term cost reductions.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENutrition Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EObesity\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENutrition Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EObesity\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EObesity is increasing in the United States and has associated health care costs, including prescription drugs. Some studies suggest that health care costs may be lower after bariatric surgery, whereas other studies show no long-term cost reductions.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EJohn M. Morton, MD, MPH, Stanford University, Stanford, California, USA, described an administrative claims-based retrospective study with the objective of determining long-term differences in pharmacy cost and utilization for severely obese patients who underwent laparoscopic bariatric surgery, compared with a nonsurgical control group. The study used the Truven Health MarketScan Commercial Claims and Encounters database of employer- and health plan-sourced medical and drug data, representing approximately 56 million covered lives from all 50 US states in the most recent full year of data (2013) [Danielson E. \u003Cem\u003ETruven Health Analytics\u003C\/em\u003E. 2014].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EPatients with a diagnosis of obesity between January 1, 2007, and December 31, 2008, were included. For these purposes, obesity was defined as a body mass index (BMI) \u2265 40 kg\/m\u003Csup\u003E2\u003C\/sup\u003E, a BMI 35 to 40 kg\/m\u003Csup\u003E2\u003C\/sup\u003E with an obesity-related comorbidity, or morbid obesity with an obesity-related comorbidity. Patients were required to have a claim with a procedure code for lap band or laparoscopic Roux-en-Y surgery in 2008 (index date). Nonsurgical controls had no bariatric surgery during the study period. Surgical patients and nonsurgical controls were aged \u2265 18 years and had no inflammatory bowel disease, familial adenomatous polyposis, noninfectious colitis, or a malignant neoplasm of digestive organs or peritoneum in the preindex period.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EControls were selected via sex, obesity category, and length of follow-up. Surgery patients were matched 1:1 with a control by propensity score according to a nearest-neighbor matching technique based on age, baseline diabetes diagnosis, baseline total costs, Deyo Charlson Comorbidity Index score, and geographic region. The final cohort included 2700 patients in each group, which were well matched.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003ECost and utilization outcomes during the 1-year baseline presurgical period and 4-year follow-up periods included total pharmacy costs, the cost of prescriptions, the proportion of patients with prescriptions, and the number of antidiabetic, antihypertensive, or other cardiac prescriptions.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EOf the 2700 surgery patients, 1833 had laparoscopic Roux-en-Y and 867 had lap band. Unadjusted pharmacy costs were 17.7% lower among surgery patients. Total pharmacy costs for the 2 groups at baseline and at 4 years are shown in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15543\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15543\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15543\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003ETotal Pharmacy Costs, $US\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-10\u0022\u003EAfter adjusting for preindex period pharmacy costs and comorbidities, the 4-year pharmacy costs were 23% lower among surgery patients when compared with controls. The number of prescriptions for cardiovascular, antihypertensive, or antidiabetic drugs increased at year 4 for all patients, but the increase was lower for surgery patients. After multivariate adjustments, the number of antidiabetic, antihypertensive, and cardiovascular prescriptions (excluding antihypertensives) were 73.7%, 48.3%, and 48.9% lower, respectively, among surgery patients as compared with controls.\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003ELimitations of this study include incomplete matching on all relevant characteristics of surgical and nonsurgical patients, the use of administrative data (which code poorly for obesity), the inclusion of commercial insurance only, the lack of laparoscopic sleeve gastrectomy data, and the lack of drug copay or supplemental insurance costs.\u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003EThe results of this study suggest that significant and sustained long-term medication cost savings may be achieved 4 years postsurgery in obese patients undergoing laparoscopic bariatric surgery when compared to those not undergoing it.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/47\/10.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzog8p\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzog8p\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}