BMC Health Serv Res. 2026 Jan 29. doi: 10.1186/s12913-025-13990-1. Online ahead of print.
ABSTRACT
BACKGROUND: The prevalence of obesity worldwide has reached pandemic levels and is anticipated to escalate swiftly in developing nations. Given the substantial surge in obesity rates observed over the last three decades, assessing obesity-related costs is imperative for informing policy decisions.
OBJECTIVES: This study aimed to estimate direct medical and non-medical costs, along with indirect costs associated with laparoscopic sleeve gastrectomy (LSG), laparoscopic Roux-en-Y bypass (LRYGB), and pharmacotherapy for obesity in adult populations in Iran.
METHODS: An economic analysis was conducted to evaluate the costs of pharmacological and surgical obesity treatments over a one-year period in 2023 from a societal perspective. This analysis incorporated direct medical costs (e.g., medications, counseling, hospitalization), direct non-medical costs (e.g., transportation), and indirect costs (e.g., lost productivity). Cost components and resource use were identified through literature reviews and expert validation. Medical tariffs and hospital bills informed medical cost estimations, while patient self-report questionnaires were utilized for non-medical and indirect cost calculations. The analysis followed established reporting guidelines and employed a micro-costing approach to ensure a comprehensive evaluation.
RESULTS: The total costs were highest for LSG (2,294.98 USD), followed by LRYGB (2,266.85 USD), and pharmacotherapy (402.67 USD). Direct medical costs represented the largest proportion of total costs for all interventions, followed by direct non-medical costs and then indirect costs. Direct non-medical costs were notably higher for LSG and LRYGB compared to pharmacotherapy, with no statistically significant difference observed between LSG and LRYGB. Indirect costs were significantly greater for surgical interventions compared to pharmacotherapy, while no significant difference was noted between LSG and LRYGB.
CONCLUSION: Surgical interventions incurred higher total costs than pharmacotherapy, primarily due to substantial direct medical costs associated with LSG. Pharmacotherapy exhibited relatively higher direct non-medical costs, and indirect costs were a notable contributor across all interventions. These findings shed light on the economic burden of obesity and advocate for further exploration of costs related to lifestyle modifications and long-term assessments. The data supports future cost-effectiveness studies, aiding decision-making in obesity management.
PMID:41612331 | DOI:10.1186/s12913-025-13990-1
