Abstract

Background: Bariatric surgery with the improvement of obesity-related diseases, increases longevity and quality of life and is more cost-effective when compared to non-surgical Procedures. Objective: The aim of this study is to compare the cost-effectiveness of Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Roux-en-Y Gastric Bypass (LRYGB). METHOD: This study was performed in two stages. Initially, a cross-sectional study was carried out for costing LSG and LRYGB in Rasoul Akram and Bahman hospitals in Tehran in the year 2014. Direct costs for each surgical procedure were calculated according to the average time of surgery in both the private and public sectors. In the second stage, using Outcome (DeltaBMI) collected by means of a systematic review study and cost data; cost effectiveness of two surgical procedures was examined by ICER analysis and compared with threshold limit. The Perspective of this analysis was health system. Results: The direct cost of services for LRYGB was 2991.5 (98121659 Rials) in the public sector and 4221.9 in the private sector. In LSG, it was 1952.9 (64055468 R) in the public sector and 3177.2 in the private sector. ICER for LSG was 720.48(23631855 R) and 716.27 (23493924 R) in private and public sector respectively. Conclusion: In this study, LSG procedure when compared to LRYGB was cost effective. The ICER obtained indicated that LSG surgery in comparison to LRYGB was 716.27 (23493924 R) and 720.48(23631855 R) in the public and private sector respectively. Moreover, per unit change in BMI was less than the threshold.