To assess the differences in short- and long-term healthcare utilization costs between patients with diabetes and obesity treated with GLP-1 receptor agonists (GLP-1RAs) and those who underwent bariatric metabolic surgery (BMS).
Approach:
Study Design: A retrospective cohort study using electronic medical record data from Clalit Health Services in Israel, matching patients who underwent BMS and those who initiated GLP-1RA treatment.
Population: Adult members of Clalit Health Services aged ≥24 years with obesity (BMI ≥30) and diabetes, followed for up to 12.5 years.
Data Collection: Individual-level information was retrieved from Clalit Health Services’ administrative and clinical data systems, capturing demographic, clinical, and healthcare utilization data.
Outcome Measures: Primary outcome was overall costs incurred by Clalit Health Services, excluding direct treatment costs. Secondary outcomes included costs of hospitalizations, medications, ambulatory care, and emergency department visits.
Key Findings:
Bariatric metabolic surgery (BMS) and GLP-1 receptor agonists (GLP-1RAs) are effective interventions for obesity and type 2 diabetes, with varying long-term healthcare costs.
The study utilized a matched cohort design to compare healthcare costs between the two treatment groups, revealing differences in overall costs incurred by Clalit Health Services.
Interpretation:
The study aims to provide insights into the economic impact of BMS versus GLP-1RA treatment from the insurer's perspective, addressing a gap in existing literature.
Limitations:
The study was conducted within a single healthcare system, which may limit generalizability.
Patients were censored for receiving alternative treatments, which could affect cost comparisons.
Conclusion:
The study provides insights into the long-term healthcare costs associated with GLP-1RAs and BMS in managing obesity and diabetes.
