Cost effectiveness and economic value of obesity surgery for Turkey (CEVOS-T)

Abstract

Introduction: Obesity and its comorbidities are among the primary challenges that health systems face globally. In Turkey, the obese population rate is 30.3%, of which 2.9% is classified under the morbidly obese category. One of the treatment alternatives is obesity surgery, which appears to be a clinically effective and cost-effective intervention for moderately to severely obese people compared with nonsurgical interventions. The objective of this article is to clarify the economic value of obesity surgery under the current reimbursement situation from the payer perspective (Social Security Instution-SSI) in Turkey. Methods: The Delphi Panel Technique was used for determining the economic value of obesity surgery. The model's incomes were generated from the Turkey Burden of Disease Study, Turkey's economic and population information and Delphi Panel consensus results. All calculations assume the SSI reimbursement perspective with the current reimbursement situation for patients above a Body Mass Index (BMI) ≥ 40 kg/m2. Results and discussion: The SSI-weighted average reimbursement price for obesity surgery was calculated as US $1,717. According to the model, the cost of an operated-upon obese patient is more than an obese patient without an operation in the first year. However, the cost of an obese patient decreased in the following years after the operation. The economic burden of the current reimbursement conditions for surgery is eliminated from the fourth year after the surgery. Conclusion: Decision makers need to account for these results for implementing new policies for obesity treatment pathways in Turkey.